U.S. patent application number 12/445403 was filed with the patent office on 2011-01-13 for souluble b-n-acetylglucoseaminidase based antibiofilm compositions and uses thereof.
This patent application is currently assigned to Kane Biotech Inc.. Invention is credited to Purushottam V. Gawande, Lasha Gogokhia, Jeffrey B. Kaplan, Karen Lovetri, Srinivasa Madhyastha, Daniel Rhoads, Nanda Yakandawala.
Application Number | 20110008402 12/445403 |
Document ID | / |
Family ID | 39282374 |
Filed Date | 2011-01-13 |
United States Patent
Application |
20110008402 |
Kind Code |
A1 |
Madhyastha; Srinivasa ; et
al. |
January 13, 2011 |
SOULUBLE B-N-ACETYLGLUCOSEAMINIDASE BASED ANTIBIOFILM COMPOSITIONS
AND USES THEREOF
Abstract
The present invention provides compositions comprising an
antibiofilm enzyme, a soluble .beta.-N-acetylglucosaminidase
similar to the dspB gene (DispersinB.TM.), and an antimicrobial for
preventing growth and proliferation of biofilm-embedded
microorganisms in acute and chronic wounds, and methods of
treatment. The invention further provides methods for preparing
medical devices, and in particular, wound care devices using
DispersinB.TM.-based antimicrobial compositions.
Inventors: |
Madhyastha; Srinivasa;
(Winnipeg, CA) ; Yakandawala; Nanda; (Winnipeg,
CA) ; Gawande; Purushottam V.; (Winnipeg, CA)
; Lovetri; Karen; (Winnipeg, CA) ; Kaplan; Jeffrey
B.; (Monsey, NJ) ; Rhoads; Daniel; (Lubbock,
TX) ; Gogokhia; Lasha; (Lubbock, TX) |
Correspondence
Address: |
MERCHANT & GOULD PC
P.O. BOX 2903
MINNEAPOLIS
MN
55402-0903
US
|
Assignee: |
Kane Biotech Inc.
Winnipeg
CA
|
Family ID: |
39282374 |
Appl. No.: |
12/445403 |
Filed: |
October 12, 2007 |
PCT Filed: |
October 12, 2007 |
PCT NO: |
PCT/CA2007/001807 |
371 Date: |
September 23, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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60829420 |
Oct 13, 2006 |
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60870762 |
Dec 19, 2006 |
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60890320 |
Feb 16, 2007 |
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60945474 |
Jun 21, 2007 |
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60950416 |
Jul 18, 2007 |
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60969355 |
Aug 31, 2007 |
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Current U.S.
Class: |
424/405 ;
424/94.4; 424/94.61 |
Current CPC
Class: |
A61L 15/46 20130101;
Y02A 50/395 20180101; A61L 2300/202 20130101; A61K 38/45 20130101;
A61P 31/00 20180101; C12N 9/2402 20130101; A61K 31/09 20130101;
C12P 19/26 20130101; A61P 17/02 20180101; A61K 38/443 20130101;
A61P 1/02 20180101; Y02A 50/473 20180101; A61L 2300/404 20130101;
A61L 2/16 20130101; A61L 29/16 20130101; A61L 2300/254 20130101;
A61K 38/40 20130101; A61L 2300/41 20130101; C12Y 302/01052
20130101; A61L 2300/45 20130101 |
Class at
Publication: |
424/405 ;
424/94.61; 424/94.4 |
International
Class: |
A61K 38/47 20060101
A61K038/47; A61K 9/14 20060101 A61K009/14; A61K 38/44 20060101
A61K038/44; A61P 31/00 20060101 A61P031/00 |
Claims
1. A composition for inhibiting biofilm-embedded microorganisms
comprising: (a) DspB polypeptide, an active fragment or variant
thereof that disperses a biofilm; and (b) an antimicrobial agent
selected from the group consisting of triclosan, rifampicin,
cefamendole nafate, nitrofurazone, bismuth thiol, bismuth
ethanedithiol (BisEDT), ciprofloxacin, ovotransferrin, lactoferrin,
sodium usnate, 5-fluorouracil, sodium dodecyl sulfate (SDS),
chlorhexidine, benzalkonium chloride, EDTA, silver nanopowder,
silver compounds, glucose oxidase, lactose peroxidase, cadexomer
iodine, methylene blue, gentian violet, medium-chain dextrans,
sugar alcohol, or mixtures thereof.
2. The composition of claim 1, wherein DspB polypeptide is the
mature DispersinB.TM. polypeptide.
3. The composition of claim 1, wherein DspB polypeptide is in a
concentration of about 1 .mu.g/ml to about 500 .mu.g/ml of the
composition.
4. (canceled)
5. The composition of claim 1, wherein the antimicrobial agent is
triclosan.
6. (canceled)
7. The composition of claim 1, wherein the antimicrobial agent is
rifampicin.
8.-18. (canceled)
19. The composition of claim 1, wherein the antimicrobial agent is
5-fluorouracil.
20.-28. (canceled)
29. The composition of claim 1, wherein the antimicrobial agent is
silver nanopowder.
30.-37. (canceled)
38. A gel formulation comprising the combination of: (a) DspB
polypeptide, and active fragment or variant thereof, that disperses
biofilms; and (b) an antimicrobial agent active against bacteria or
fungi: and (c) a viscosity increasing agent, wherein the
antimicrobial agent is selected from a group consisting of
triclosan, rifampicin, cefamendole nafate, nitrofurazone, bismuth
thiol, bismuth ethanedithiol (BisEDT), ciprofloxacin,
ovotransferrin, lactoferrin, sodium usnate, 5-fluorouracil, sodium
dodecyl sulfate (SDS), chlorhexidine, benzalkonium chloride, EDTA,
silver nanopowder, silver compounds, glucose oxidase, lactose
peroxidase, cadexomer iodine, methylene blue, gentian violet,
medium-chain dextrans, sugar alcohol, and mixtures thereof.
39. The formulation of claim 38, wherein DspB polypeptide, active
fragment or variant thereof, is about 0.001% to 0.1% by weight
40. (canceled)
41. The formulation of claim 38, wherein the antimicrobial agent is
triclosan.
42.-46. (canceled)
47. The formulation of claim 38, wherein the viscosity increasing
agent comprises an alginate-based material.
48.-50. (canceled)
51. The formulation of claim 38, wherein the formulation is in the
form of a formable or pliable putty or flexible sheets that can be
readily moulded and cut into shape.
52. A wound dressing or covering comprising the formulation of
claim 38.
53.-78. (canceled)
79. A composition for inhibiting biofilm-embedded microorganisms
comprising: (a) DspB polypeptide, an active fragment or variant
thereof that disperses a biofilm; and (b) a bacteriophage.
80.-81. (canceled)
82. A composition according to claim 79 wherein the bacteriophage
displays DspB polypeptide.
83.-84. (canceled)
85. The composition of claim 82, wherein the DspB polypeptide is
fused to the minor coat protein.
86.-110. (canceled)
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority to U.S. provisional
application No. 60/829,420, filed on Oct. 13, 2006, U.S.
provisional application No. 60/870,762, filed Dec. 19, 2006, U.S.
provisional application No. 60/890,320, filed Feb. 16, 2007, U.S.
provisional application No. 60/945,474, filed Jun. 21, 2007, U.S.
provisional application No. 60/950,416, filed Jul. 18, 2007 and
U.S. provisional application No. 60/969,355, filed Aug. 31,
2007.
FIELD OF THE INVENTION
[0002] The present invention relates to antibiofilm enzyme
DispersinB.TM.-based antimicrobial compositions that inhibit growth
and proliferation of bionlin-embedded microorganisms, and methods
of administering the compositions.
BACKGROUND
[0003] From a microbiological perspective, the primary function of
normal, intact skin is to control microbial populations that live
on the skin surface and to prevent underlying tissue from becoming
colonized and invaded by potential pathogens. Exposure of
subcutaneous tissue (i.e. a wound) provides a moist, warm and
nutritious environment that is conducive to microbial colonization
and proliferation.
[0004] Since wound colonization is mostly polymicrobial, involving
numerous microorganisms that are potentially pathogenic, any wound
is at some risk of becoming infected. In the event of an infection
a wound fails to heal, the patient suffers increased trauma as well
as increased treatment costs. General wound management practices
become more resource demanding. Wounds are an enormous problem
worldwide. Approximately 1% of the world's population suffers a
venous leg ulcer (Ruckley, 1997. Angiology, 48: 67-69). Friedberg
et al. estimated the annual cost for dealing with venous leg ulcers
in 192 patients to be $1.26 million (Friedberg et al., 2002. J.
Wound. Ostomy. Continence. Nurs. 29: 186-192). This equals 6.5
billion of direct wound care cost for every 1 million venous leg
ulcer patients. Pressure ulcers are a common and expensive wound
care problem in acute care, nursing homes and home care
populations. For decubitus ulcer, Stausberg et al. (2005)
demonstrated 1% incidence rate along with a 5% prevalence rate for
hospital patients (Stausberg et al., 2005 Adv. Skin Wound. Care,
18: 140-145). Bennett et al. found that the management of decubitus
ulcers costs approximately 3-4 billion dollars annually in the
United Kingdom, which is over 4% of the total National Health
Service expenditure in the United Kingdom (Bennett et al., 2004.
Ageing, 33: 230-235). In the United States, diabetic foot ulcers in
2004 consumed approximately 10 billion dollars in direct cost
(approximately 4% of the total personal health spending of the
United States) and another $5 billion in indirect cost (disability,
nursing homes, etc.). Diabetic foot ulcers caused over 100,000
major diabetic limb amputations. The cost for each amputation when
factoring in associated costs was $100,000 in 2005, resulting in
$10 billion in direct cost (Heyneman and Lawless-Liday, 2002.
Critical Care Nurse, 22: 52-60). Wounds are becoming an increased
portion of the cost of the healthcare system.
[0005] Thus, concern among health care practitioners regarding the
risk of wound infection is justifiable not only in terms of
increased trauma to the patient but also in view of its burden on
financial resources and the increasing requirement for
cost-effective management within the health care system. Most wound
infections are caused by Staphylococcus aureus (20%),
Staphylococcus epidermidis (14%), Enterococci spp. (12%),
Escherichia coli (8%), Pseudomonas aeruginosa (8%), Enterobacter
spp. (7%), Proteus spp. (3%), Klebsiella pneumoniae (3%),
Streptococci (3%) and Candida albicans (3%) (CDC Report on common
bacterial species associated with wound infections, 1996).
[0006] In recent years, there have been numerous efforts to use
antibiotics and antimicrobials for the treatment of non-healing,
clinically infected wounds. These antimicrobial agents are of
varying chemical composition and can include peptides (Zaleski et
al., 2006, Antimicrob. Agents Chemother., 50: 3856-3860),
antiseptics (U.S. Pat. No. 6,700,032), antibiotics (Rothstein, et
al., 2006, Antimicrob. Agents Chemother, 50: 3658-3664;
Rittenhouse, et al., 2006, Antimicrob. Agents Chemother. 50:
3886-3888), silver ions/compounds (US patent appl. pub. no.
200510035327), chitosan (US patent appl. pub. no. 2006/0210613;
U.S. Pat. No. 6,998,509), nitrofurazone (Munster, 1984, J. Trauma
24: 524-525), bismuth thiols (Domenico, et al., 2000, Infect. Med.
17: 123-127), and xylitol (WO 2005/058381).
[0007] There have been various attempts by others to create wound
care devices such as dressings or bandages, gels and ointments
comprising antimicrobial agents. For example, U.S. Pat. No.
3,930,000 discloses the use of a silver zinc allantoinate cream for
killing bacteria and fungi associated with burn wounds. Another
example is silver sulfadiazine (SILVA-DINE.RTM.), which has been
shown to be effective when tested in vitro against 50 strains of
methicillin resistant S. aureus (MRSA). Numerous products are
commercially available with different trade names that employ
silver as antimicrobial agents such as STERTPURE.RTM., A.M.Y.,
ACTICOAT.TM., ACTISORB.RTM., and SILVERLON.RTM..
[0008] U.S. Pat. No. 7,091,336 teaches the process of making a gel
containing gellan gum that increases in viscosity once applied to
the wound to form an immobile gel. One example of a commercially
available wound gel is INTRASITE.RTM., contains carboxymethyl
cellulose as a main ingredient. U.S. Pat. No. 6,700,032 discloses
the application of triclosan in wound dressing fabricated from a
natural or synthetic film-forming material, such as hydrophobic
polymeric membrane. DeBusk and Alleman disclose a wound dressing
that has been infused with a suspension of starch hydrolysate
containing collagen and .alpha.-tocopherol acetate (U.S. patent
appl. Pub. No. 2004/0001878). Wounds, in particular those occurring
in the skin as second and third degree burns, stasis ulcers, tropic
lesions, such as decubitus ulcers, severe cuts and abrasions that
are commonly resistant to the natural healing process, may be
treated with the infused dressing. Progress has been made on
developing wound care devices, but each of the wound etiologies are
increasing at double digit rates annually, causing the number of
wounds to double every 4-5 years (Drosou et al., 2003, Wounds,
15:149-166).
[0009] Wounds often have multiple barriers to healing. Wound
healing and infection is influenced by the relationship between the
ability of bacteria to create a stable, prosperous community within
a wound environment and the ability of the host to control the
bacterial community. Since bacteria are rapidly able to form their
own protective microenvironment (biofilm) following their
attachment to a surface, the ability of the host to control these
organisms is likely to decrease as the biofilm community matures.
Within a stable biofilm community, interactions between aerobic and
anaerobic bacteria are likely to increase their net pathogenic
effect, enhancing their potential to cause infection and delay
healing. Over the last few years, some have linked biofilm to
chronic wounds (Mertz, 2003, Wounds, 15: 1-9). Microscopic
evaluation of chronic wounds showed well organized biofilm with
extracellular polymeric substance adhered around colony bacteria in
at least 60% of the chronic wounds (Mertz, 2003, Wounds,
15:1-9).
[0010] In addition to a direct effect on wound healing by the
production of destructive enzymes and toxins, mixed communities of
microorganisms may also indirectly affect healing by promoting a
chronic inflammatory state. Prolonged exposure to bacteria within a
chronic wound leads to a prolonged inflammatory response, resulting
in the release of free radicals and numerous lytic enzymes that
could have a detrimental effect on cellular processes involved in
wound healing. Proteinases released from a number of bacteria,
particularly Pseudomonas aeruginosa, are known to affect growth
factors and many other tissue proteins that are necessary for the
wound healing process (Steed et al., 1996, J. Am. Coll. Surg, 183:
(51-64; Travis et al., 1995, Trends Microbiol. 3: 405-407). The
increased production of exudates that often accompanies increased
microbial load has been associated with the degradation of growth
factors and matrix metalloproteinases (MMPs), which subsequently
affect cell proliferation and wound healing (galanga et al., 1994,
J Invest Dermatol. 1: 125-127).
[0011] Dental plaque is a host-associated biofilm that adheres to
the tooth surface both above and below the gingival margin. Dental
plaque consists mainly of microorganisms with a small number of
epithelial cells, leukocytes, and macrophages in an intracellular
matrix. It has been postulated that there are approximately 300 to
400 different bacterial species in dental plaque (Moore, 1987, J.
Periodont. Res. 22: 335-341). Periodontal disease comprises a
collection of inflammatory conditions of the periodontium (gingiva,
periodontal ligament, cementum, and alveolar bone) due to a chronic
bacterial infection, i.e., dental plaque. Over 90% of the
population of the United States is affected by periodontal disease
(Brown et al., 1996, J. Dent. Res. 75: 672-683).
[0012] In addition to peridontal diseases, other
conditions/diseases caused by biofilms include cystic fibrosis,
pneumonia, native valve endocarditis and otitis media (Costerton et
al. Science 1999 284:1318-1322). Biofilm is also implicated in the
infection of various medical devices such as urinary catheters,
mechanical heart valves, cardiac pacemakers, prosthetic joints, and
contact lenses (Donlan, R. M. 2001 Emerging Infect. Dis.
7:277-281). For example, urinary tract infection (UTI) is the most
common hospital-acquired infection, accounting for up to 40% of all
nosocomial infections. The majority of cases of UTIs are associated
with the use of urinary catheters, including trans-urethral Foley,
suprapubic, and nephrostomy catheters. These urinary catheters are
inserted in a variety of populations, including the elderly, stroke
victims, spinal cord-injured patients, post-operative patients and
those with obstructive uropathy. Despite adherence to sterile
guidelines for the insertion and maintenance of urinary catheters,
catheter-associated UTIs continue to pose a major problem. For
instance, it is estimated that almost one-quarter of hospitalized
spinal cord-injured patients develop symptomatic UTIs during their
hospital course. Gram-negative bacilli account for almost 60-70%,
Enterococci for about 25%, and Candida species for about 10% of
cases of catheter-associated UTI.
[0013] Furthermore, indwelling medical devices including vascular
catheters are becoming essential in the management of hospitalized
patients by providing venous access. The benefit derived from these
catheters as well as other types of medical devices such as
peritoneal catheters, cardiovascular devices, orthopedic implants,
and other prosthetic devices is often offset by infectious
complications. The most common organisms causing these infectious
complications are Staphylococcus epitkonidis and Staphylococcus
aureus. In the case of vascular catheters, these two organisms
account for almost 70-80% of all infectious organisms, with
Staphylococcus epidermidis being the most common organism. Fungi
also form biofilms of clinical significance. Candida albicans, a
fungal agent, accounts for 10-15% of catheter infections.
[0014] Bacteria and fungi growing in biofilms exhibit increased
resistance to antimicrobial agents and are nearly impossible to
eradicate using known techniques. The present invention teaches
applications of an antibiofilm enzyme DispersinB.TM.-based
antimicrobial composition in devices, methods for preparing such
devices, and methods of treating wounds and oral infections.
SUMMARY OF THE INVENTION
[0015] In one embodiment, the present invention provides a
composition for preventing and/or inhibiting growth or
proliferation of biofilm-embedded microorganisms comprising: (a) a
first compound comprising DispersinB.TM., an active fragment or
variant thereof that disperses a biofilm; and (b) a second compound
comprising an antimicrobial agent active against bacteria or
fungi.
[0016] in an embodiment, DspB is in a concentration of about 5 to
about 500 .mu.g/ml. In another embodiment, DspB is in a
concentration of about 10 to about 250 .mu.g/ml. In another
embodiment, DispersinB.TM. is in a concentration of about 25 ng/ml
to about 100 ug/ml.
[0017] In another embodiment, an antimicrobial agent can include
triclosan, antibiotics (such as rifampicin, cefamandole nafate and
ciprofloxacin), nitrofurazone, bismuth-thiols [such as bismuth
ethancdithiol (BisEDT)], ehitosan, epigallocatechin gallate (EGCG),
sodium usnate, antineoplastic agents (such as 5-fluorouracil),
detergents (such as SDS, benzalkonium chloride), chlorhexidine,
chelating agents (such as EDTA), silver compounds, bacteriophage,
antimicrobial enzymes (such as glucose oxidase and
lactoperoxidase), sugar alcohols (such as xylitol), maleimides
[such as N,N-(1,2 phenylene) dimaleimide (oPDM) and N-(1-pyrenyl)
maleimide (PyrM)], cadexomer iodine, methylene blue, gentian
violet, or medium chain dextrans (such as honey).
[0018] In a further embodiment, an antimicrobial agent can include
triclosan, and can be in a concentration of about 0.1 .mu.g/ml to
about 50 mg/ml. In another embodiment, the concentration is about
0.2 .mu.g/ml to about 25 mg/ml and in a still further embodiment,
the concentration is about 0.325 .mu.g ml to about 10 mg/ml.
[0019] In yet another embodiment, an antimicrobial agent can
include, but is not limited to, (i) rifampicin in a concentration
of about 0.1 to about 1000 .mu.g/ml, preferably about 1 to about
100, and more preferably about 10 to about 50 .mu.g/ml; (ii)
cefamandole nafate in a concentration of about 0.01 to about 10
.mu.g/ml, preferably about 0.05 to about 5 .mu.g/ml, and more 0.1
to about 2 .mu.g/ml. (iii) nitrofurazone in a concentration of
about 0.01 to about 1 mg/ml, preferably about 0.1 to about 1 mg/ml,
and more preferably about 0.5 to about 1 mg/ml; (iv) bismuth
ethanedithiol (BisEDT) in a concentration of about 0.01 to about 5
mM, preferably about 0.1 to about 2 mM, and more preferably about 1
mM, (v) ciprofloxacin in a concentration of about 0.01 to about 1.0
mg/ml; preferably about 0.05 to about 0.5 mg/ml and more preferably
about 0.1 mg/ml; (vi) epigallocatechin gallate in a concentration
of about 10 to about 100 .mu.g ml, preferably about 25 to about 50
.mu.g/ml, or more preferably about 50 .mu.g/ml; (vii) sodium usnate
in a concentration of about 10 to about 750 .mu.g/ml, preferably
about 100 to about 500 .mu.g/ml or more preferably 200 to about 400
.mu.g/ml; (vii) ovotransferrin in a concentration of about 10 to
about 1000 mg/ml, preferably about 25 to about 500 mg/ml or more
preferably about 50 to about 200 mg/ml; (ix) sodium doccyl sulfate
in a concentration of about 0.01 to about 100 mg/ml, more
preferably about 0.05 mg/ml to about 50 mg/ml and more preferably
about 0.1 mg/ml to about 10 mg/ml; (x) 5-fluorouracil in a
concentration of about 1 to about 1000 .mu.g/ml, preferably about
10 to about 500 .mu.g/ml and more preferably about 25 to 100
.mu.g/ml; (xi) chlorhexidine in a concentration of about 0.01
.mu.g/ml to about 100 .mu.g/ml, preferably about 0.1 .mu.g/ml to
about 10 .mu.g/ml, and more preferably about 1 .mu.g/ml to about 5
.mu.g/ml; (xii) benzalkonium chloride 0.01 .mu.g/ml to about 100
.mu.g/ml, preferably about 0.1 .mu.g/ml to about 10 .mu.g/ml, and
more preferably about 1 .mu.g/ml to about 5 .mu.g/ml; (xiii) EDTA
in a concentration of about 1 to about 1000 .mu.g/ml, preferably
about 10 to about 100 .mu.g/ml and more preferably about 25 to
about 50 .mu.g/ml; or (xv) silver nanopowder in a concentration of
0.01 .mu.g/ml to about 100 .mu.g/ml, preferably about 0.1 .mu.g/ml
to about 10 .mu.g/ml, and more preferably about 1 .mu.g/ml to about
5 .mu.g/ml.
[0020] An embodiment of the invention includes a method of
inhibiting biofilm-embedded microorganisms comprising administering
an effective amount of DispersinB.TM., an active fragment, or
variant thereof that disperses a biofilm; and an effective amount
of an antimicrobial agent or a mixture of an antimicrobial
agent.
[0021] in another embodiment, the DispersinB.TM., an active
fragment, or variant thereof is administered prior to
administration of the antimicrobial agent and the antimicrobial
agent is sodium doceyl sulfate, chlorhexidine, or benzalkonium
chloride.
[0022] An embodiment of the invention includes a method of treating
an infection by administering a composition comprising (a)
Dispersin.TM., a DispersinB.TM. fragment, or variant thereof; and
(b) an antimicrobial agent or a mixture of an antimicrobial
agent.
[0023] In yet another embodiment, a DispersinB.TM.-based
antimicrobial composition can treat various kinds of wounds,
including, but not limited to, cutaneous abscess, surgical wounds,
sutured lacerations, contaminated lacerations, burn wounds such as
partial and full thickness burns, decubitus ulcers, stasis ulcers,
leg ulcers, foot ulcers, venous ulcers, diabetic ulcers, ischemic
ulcers, and pressure ulcers.
[0024] In another embodiment, a DispersinB.TM.-based antimicrobial
composition can treat an oral infection. Oral infections include
microorganisms in the subgingival and supragingival plaque.
Subgingival plaque comprising microorganisms can cause periodontal
disease. The compositions of the present invention can be used in
the treatment of periodontal disease. The compositions of the
present invention can be used in the treatment of localized
juvenile periodontitis.
[0025] Biofilm microorganisms can be bacteria, such as
gram-negative Escherichia coli, Proteus mirabilis, Klebsiella
pneumoniae, Bacteroides spp., Porphyromonas spp., Prevotella spp.,
Fusobacterium nucleatum, Aggregatibacter cictinontycetemcomitans
(formerrly Actinobacillus actinomycetemcomitans), Treponema
denticola, or Pseudomonas aeruginosa, and gram-positive
Enterococcus faecalis, Enterococcus cloacae, Vancomycin Resistant
Enterococci (VRE), Streptococcus spp. Peptostreptococcus spp.,
Staphylococcus epidermidis, or Staphylococcus aureus. Furthermore,
a wound-associated microorganism can be fungi, such as Candida
albicans.
[0026] One embodiment or the present invention includes providing
methods of using a DispersinB.TM.-based composition or compositions
in wound care devices such as non-resorbable gauze/sponge dressing,
hydrophilic wound dressing, occlusive wound dressing, hydrogel
wound, and burn dressing. The present invention also includes use
of a spray-applicator containing a DispersinB.TM.-based
antimicrobial composition as a wound care device. Another
embodiment of the invention includes a wound care device comprising
a DispersinB.TM. based composition or compositions.
[0027] An additional aspect of the present invention includes wound
care ointments, gels, and lotions comprising DispersinB.TM. and an
antimicrobial agent. An embodiment of the present invention also
includes wound care sutures coated with DispersinB.TM. and an
antimicrobial agent.
[0028] Furthermore, a composition can comprise binders, wetting
agents, odor absorbing agents, levelling agents, adherents,
thickeners, and the like. Other additives may be present on and/or
within a fabric of bandage including antistatic agents, optical
brightening compounds, opacifiers (e.g., titanium dioxide),
nucleating agents, antioxidants, UV stabilizers, fillers, permanent
press finishes, softeners, lubricants, curing accelerators,
adhesives, and the like.
[0029] In another embodiment, the present invention includes wound
gel compositions for: (a) DispersinB.TM. antimicrobial wound gel
with a viscosity improving agent; and (b) Triclosan-DispersinB.TM.
antimicrobial wound gel with a viscosity improving agent. A
DispersinB.TM. or Triclosan-DispersinB.TM. wound gel can include
DispersinB.TM., an active fragment or variant thereof.
[0030] In another embodiment, an antimicrobial agent can include,
but is not limited to, triclosan, antibiotics (such as rifampicin,
cefamandole nafate and ciprofloxacin) nitrofurazone, bismuth-thiols
[such as bismuth ethanedithiol (BisEDT)], chitosan,
Epigallocatechin gallate (EGCG), sodium usnate, antineoplastic
agents (such as 5-fluorouracil), detergents (such as SDS,
benzalkonium chloride), chlorhexidine, chelating agents (such as
EDTA), silver compounds, bacteriophage, antimicrobial enzymes (such
as glucose oxidase and lactoperoxidase), sugar alcohols (such as
xylitol), maleimides [such as N,N-(1,2 phenylene) dimaleimide
(oPDM) and N-(1-pyrenyl) maleimide (PyrM)], cadexomer iodine,
methylene blue, gentian violet, medium chain dextrans (such as
honey), and mixtures thereof can be used in combination with
DispersinB.TM..
[0031] In a further embodiment, a Triclosan-DispersinB.TM. wound
gel comprises of about 1 to about 10% triclosan, preferably of
about 5 to about 10% triclosan and more preferably, about 1%
triclosan. In a further embodiment, a DispersinB.TM. wound gel and
a Triclosan-DispersinB.TM. wound gel can optionally further
comprise a gelling agent and/or a viscosity increasing agent.
[0032] Triclosan-DispersinB.TM. wound gel can be prepared in
polyethylene glycol (PEG)/ethanol PEG of different molecular
weights ranging from about 200 to about 511,000 can be used in a
gel formulation. In an embodiment, a Triclosan-DispersinB.TM. wound
gel is prepared in 10% PEG-400/10% ethanol.
[0033] In a further embodiment, gelling agents in a wound gel
include, but are not limited to, gums, polysaccharides, alginates,
synthetic polymeric compounds, natural polymeric compounds, and
mixtures thereof.
[0034] DispersinB.TM.-based antimicrobial wound gels of the present
invention can be used to inhibit the proliferation of
biofilm-embedded gram-negative and gram-positive bacteria, which
include, but are not limited to, Escherichia coli, Proteus
mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa,
Klebsiella oxytoca, Providentia sturtii, Serratia marcescens,
Enterococcus faecalis, Vancomycin Resistant Enterococci (VRE),
Peptostreptococcus spp., Corynebacterium spp., Clostridium spp.,
Bacteriodes spp., Prevotella spp., Streptococcus pyogenes,
Streptococcus viridans, Micrococcus spp., Beta-hemolytic
streptococcus (group C), Beta-hemolytic streptococcus (group B),
Bacillus spp., Porphyromonas spp., Enterobacter cloacae, S.
epidermidis, S. aureus, Staphylococcus agalactiae, and
Staphylococcus saprophyticus.
[0035] Additionally, DispersinB.TM. based antimicrobial
compositions of the invention can also be used to inhibit
proliferation of biofilm-embedded fungi, such as Candida albicans,
Candida parapsilosis, and Candida utilis.
[0036] in one embodiment, a DispersinB.TM.-based antimicrobial
wound gel can be used for treating wounds including, but is not
limited to, a cutaneous abscess, surgical wound, sutured
laceration, contaminated laceration, blister wound, soft tissue
wound, partial thickness burn, full thickness burn, decubitus
ulcer, stasis ulcer, foot ulcer, venous ulcer, diabetic ulcer,
ischemic ulcer, pressure ulcer, or combinations thereof.
[0037] Another embodiment, the present invention provides a method
of preparing a device comprising treating at least one surface of
the device with a composition as herein described. For example, the
composition can be incorporated into polymers, wherein said
polymers are used to form the device. Another aspect of the present
invention is a method of preparing a device comprising coating the
composition as herein described onto the inner and/or outer surface
of a device.
[0038] In another embodiment, the DispersinB.TM. is about 0.1 to
about 500 .mu.g/ml of the composition, preferably about 1 to about
350 .mu.g/ml of the composition or more preferably about 10 to
about 100 .mu.g/ml of the composition. In yet another embodiment,
the antimicrobial agent is triclosan, rifampicin, cefamandole
nafate, nitrofurazone, ciprofloxacin, minocycline, gentamycin,
silver compounds, chlorhexidine, 5-fluorouracil or a
bisphosphonate, preferably rifampicin, cefamendole nafate,
nitroforazone, or triclosan, more preferably triclosan. In one
embodiment, the triclosan is in a concentration of about 0.01 to
about 100 mg/ml of the composition, preferably about 0.1 to about
100 mg/ml of the composition or more preferably about 1 to about
100 mg/ml of the composition. In another embodiment, the
antibacterial agent is rifampicin in a concentration of about 10 to
about 1000 .mu.g/ml of the composition, preferably about 100 to
about 1000 .mu.g/ml of the composition or more preferably about 10
to about 100 .mu.g/ml of the composition. In another embodiment,
the antibacterial agent is cefamandole nafate in a concentration of
about 0.05 to 5 .mu.g/ml of the composition, preferably about 0.5
to about 5 .mu.g/ml of the composition, or more preferably, about 1
to about 5 .mu.g/ml of the composition. In another embodiment, the
antibacterial agent is nitrofurazone in a concentration of about
0.01 to about 1 mg/ml of the composition, preferably about 0.1 to
about 1 mg/ml of the composition, and more preferably about 0.5 to
about 1 mg/ml of the composition. In one embodiment of the present
invention, the composition comprises effective amounts of
DispersinB.TM. and triclosan. In another embodiment of the present
invention, the composition comprises effective amounts of
DispersinB.TM. and rifampicin. In yet another embodiment of the
present invention, the composition comprises effective amounts of
DispersinB.TM. and cefamandole nafate. In yet another embodiment of
the present invention, the composition comprises effective amounts
of DispersinB.TM. and nitrofurazone.
[0039] In one aspect of the present invention, the device is a
medical device, such as a catheter, for example, an indwelling
catheter such as a central venous catheter, a peripheral
intravenous catheter, an arterial catheter, a peritoneal catheter,
a haemodialysis catheter, an umbilical catheter, percutaneous
nontunneled silicone catheter, a cuffed tunneled central venous
catheter, an endotracheal tube, a subcutaneous central venous port,
urinary catheter, a peritoneal catheter, a peripheral intravenous
catheter or a central venous catheter.
[0040] In another embodiment of the present invention, the medical
devices are catheters, pacemakers, prosthetic heart valves,
prosthetic joints, voice prostheses, contact lenses, a shunt, heart
valve, penile implant, small or temporary joint replacement,
urinary dilator, cannula, elastomer, or intrauterine devices.
[0041] In another embodiment of the present invention, the device
is a catheter lock, a needle, a Leur-Lok.RTM. connector, a
needleless connector, a clamp, a forcep, a scissor, a skin hook, a
tubing, a needle, a retractor, a scaler, a drill, a chisel, a rasp,
a surgical instrument, a dental instrument, a tube, an intravenous
tube, a breathing tube, a dental water line, a dental drain tube, a
feeding tube, a bandage, a wound dressing, an orthopedic implant,
or a saw.
[0042] Another embodiment of the present invention is a method of
preparing a device comprising coating a composition herein
described onto at least one surface of the device.
[0043] Another embodiment of the present invention is a device
coated, impregnated, or treated with a composition as herein
described, for example, a medical device such as a catheter, for
example an indwelling catheter such as a central venous catheter, a
peripheral intravenous catheter, an arterial catheter, a peritoneal
catheter, a haemodialysis catheter, an umbilical catheter,
percutaneous nontunneled silicone catheter, a cuffed tunneled
central venous catheter, an endotracheal tube, a urinary catheter,
a peritoneal catheter, a peripheral intravenous catheter and
central venous catheter or a subcutaneous central venous port.
[0044] A device may also be catheters, pacemakers, prosthetic heart
valves, prosthetic joints, voice prostheses, contact lenses, a
stunt, heart valve, penile implant, small or temporary joint
replacement, urinary dilator, cannula, elastomer, intrauterine
devices, catheter lock, a needle, a Leur-Lok.RTM. connector, a
needleless connector, a clamp, a forcep, a scissor, a skin hook, a
tubing, a needle, a retractor, a scaler, a drill, a chisel, a rasp,
a surgical instrument, a dental instrument, a tube, an intravenous
tube, a breathing tube, a dental water line, a dental drain lube, a
feeding tube, a bandage, a wound dressing, an orthopedic implant,
or a saw.
[0045] Another embodiment of the present invention is a method of
preventing device or catheter-related infection in a mammal, said
method comprising coating, incorporating, or treating a device or
catheter to be implanted with a composition as herein described.
Another embodiment of the present invention is a method of
preventing an infection caused by a device or catheter in a mammal,
said method comprising coating, incorporating or treating the
device or catheter with a composition as herein described.
[0046] Another embodiment of the present invention is the use of a
composition as herein described in the preparation or a medical
device for implantation in a mammal. In one embodiment, a medical
device may be coated, incorporated, or treated with a composition.
In another embodiment, the composition may prevent urinary tract
infection. Another aspect of the present invention is the use
wherein the composition prevents urinary or vascular infection.
[0047] In another embodiment, the present invention provides a
composition for inhibiting biofilm-embedded microorganisms
comprising: (a) DispersinB.TM., an active fragment or variant
thereof that disperses a biofilm; and (b) a bacteriophage. The
composition can comprise about 10.sup.8 bacteriophage. The
bacteriophage can comprise more than one species of
bacteriophage.
[0048] In another embodiment, the present invention provides a
composition for inhibiting biofilm-embedded microorganisms
comprising a recombinant bacteriophage, wherein the recombinant
bacteriophage displays DispersinB.TM.. The displayed DispersinB.TM.
can be fused to a phage coat protein. The DispersinB.TM. can be
fused to the major coat protein or the minor coat protein. In
another embodiment, the present invention provides a fusion protein
comprising at least a portion of a phage coat protein bonded to
DispersinB.TM..
BRIEF DESCRIPTION OF THE FIGURES
[0049] FIG. 1 is a bar graph showing the effect of DispersinB.TM.
on Escherichia Staphylococcus epidermidis and Staphylococcus aureus
biofilm formation. All three bacterial strains were grown
separately in a media without DispersinB.TM. as a negative
control.
[0050] FIG. 2 shows the effect of DispersinB.TM. in polystyrene
tubes on S. epidermidis biofilm dispersal.
[0051] FIG. 3 is bar graph showing an enhanced inhibitory effect of
a DispersinB.TM. and Triclosan (TCSN) combination on S. epidermidis
biofilm formation. Planktonic (.quadrature.) and biofilm
(.box-solid.) S. epidermidis growth was measured in media with no
antimicrobials (control), DispersinB.TM. (25, 50, and 100 ng/ml),
TCSN (25, 50, and 100 .mu.g/ml), and the combination of
DispersinB.TM. (25, 50, or 100 ng/ml) and TCSN (25, 50, and 100
.mu.g/ml).
[0052] FIG. 4 is bar graph showing an enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to rifampicin. S. epidermis growth was measured in
media with no antimicrobials (control), DispersinB.TM. (20
.mu.g/ml), rifampicin (100 .mu.g/ml), and a combination of
DispersinB.TM. (20 .mu.g/ml) and rifampicin (100 .mu.g/ml).
[0053] FIG. 5 is bar graph showing an enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to cefamandole nafate. S. epidermidis growth was
measured in media with no antimicrobials (control), DispersinB.TM.
(20 .mu.g/ml), cefamandole nafate (0.1 .mu.g/ml), and a combination
of DispersinB.TM. (20 .mu.g/ml) and cefamandole nafate (0.1
.mu.g/ml).
[0054] FIG. 6 is bar graph showings an enhanced effect of
DispersinB.TM. on the sensitivity of bin film-embedded S.
epidermidis to nitrofurazone. S. epidermis growth was measured in
media with no antimicrobials (control), DispersinB.TM. (20
.mu.g/ml), nitrofurazone (25 .mu.g/ml), and a combination of
DispersinB.TM. (20 .mu.g/ml) and nitrofurazone (25 .mu.g/ml).
[0055] FIG. 7 is bar graph showing an enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to bismuth ethanedithiol (BisEDT). S. epidermidis
growth was measured in media with no antimicrobials (control),
DispersinB.TM. (20 .mu.g/ml), BisEDT (0.5 mM), and a combination of
DispersinB.TM. (20 .mu.g/ml) and BisEDT (0.5 mM).
[0056] FIG. 8 is bar graph showing an enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to ciprofloxacin (CF). S. epidermidis growth was
measured in media with no antimicrobials (control), DispersinB.TM.
(20 .mu.g/ml), CF (200 .mu.g/ml), and a combination of
DispersinB.TM. (20 .mu.g/ml) and CF (200 .mu.g/ml).
[0057] FIG. 9 is a bar graph showing an enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to lactoferrin (Lf). S. epidermidis growth was measured
in media with no antimicrobials (control), DispersinB.TM. (20
.mu.g/ml), Lf (5 mg/ml), and a combination of DispersinB.TM. (20
.mu.g/ml) and Lf (5 mg/ml).
[0058] FIG. 10 is bar graph showing an enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to conalbumin/ovotransferrin (OT). S. epidermis growth
was measured in media with no antimicrobials (control),
DispersinB.TM. (20 .mu.g/ml), OT (10 mg/ml), and a combination of
DispersinB.TM. (20 .mu.g/ml) and OT (10 mg/ml).
[0059] FIG. 11 is bar graph showing an enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to gallium (III) nitrate. S. epidermis growth was
measured in media with no antimicrobials (control), DispersinB.TM.
(20 .mu.g/ml), gallium (III) nitrate (5 mg/ml), and a combination
of DispersinB.TM. (20 .mu.g/ml) and gallium (III) nitrate (5
mg/ml).
[0060] FIG. 12 is bar graph showing an enhanced effect
oiDispersinB.TM. ort the sensitivity of biofilm-embedded S.
epidermidis to chitosan. S. epidermidis growth was measured in
media with no antimicrobials (control), DispersinB.TM. (20
.mu.g/ml), chitosan (2 mg/ml), and a combination of DispersinB.TM.
(20 .mu.g/ml) and chitosan (2 mg/ml).
[0061] FIG. 13 is bar graph showing an effect of DispersinB.TM. and
Epigallocatechin gallate (EGCG) alone and in combination on S.
epidermidis biofilm formation. S. epidermidis growth was measured
in media with no antimicrobials (control), DispersinB.TM. (50
.mu.g/ml), EGCG (100 ng/ml), and a combination of DispersinB.TM.
(50 .mu.g/ml) and EGCG (100 ng/ml).
[0062] FIG. 14 is bar graph showing an effect of DispersinB.TM. and
Epigallocatechin gallate (EGCG) alone and in combination on S.
aureus biofilm formation. S. aureus growth was measured in
conditions of no antimicrobials (control), DispersinB.TM. (50
.mu.g/m I), EGCG (100 ng/ml), and a combination of DispersinB.TM.
(50 .mu.g ml) and EGCG (100 ng/ml).
[0063] FIG. 15 is bar graph showing an effect of DispersinB.TM. and
triclosan alone and in combination on biofilm-embedded S.
epidermidis. S. epidermidis growth was measured in media with no
antimicrobials (control), DispersinB.TM. (20 .mu.g/ml), triclosan
(1 mg/ml), and a combination of DispersinB.TM. (20 .mu.g/ml) and
EGCG (1 mg/ml).
[0064] FIG. 16 is bar graph showing an effect of DispersinB.TM. and
sodium (Na) usnate alone and in combination on biofilm-embedded S.
epidermidis. S. epidermidis growth was measured in media with no
antimicrobials (control), DispersinB.TM. (50 .mu.g/ml), Na usnate
(500 .mu.g/ml), and a combination of DispersinB.TM. (50 .mu.g/ml)
and Na usnate (500 .mu.g/ml).
[0065] FIG. 17 is bar graph showing an enhanced inhibitory effect
of DispersinB.TM. and Triclosan (TCSN) combination on
coagulase-negative Staphylococci (CNS) biofilm formation.
Planktonic (.quadrature.) and biofilm growth (.box-solid.) were
measured in media with no antimicrobials (control), DispersinB.TM.
(25, 50, and 100 TCSN (0.325, 0.625, and 1.25 .mu.g/ml), and a
combination of DispersinB.TM. (25, 50, and 100 ng/ml) and TCSN
0.325, 0.625, and 1.25 .mu.g/ml).
[0066] FIG. 18 is bar graph showing enhanced effect of
DispersinB.TM. on the sensitivity of biofilm-embedded S.
epidermidis to 5-fluorouracil (5-FU). S. epidermidis growth was
measured in media with no antimicrobials (control), DispersinB.TM.
(20 .mu.g/ml), 5-FU (100 .mu.g/ml), and a combination of
DispersinB.TM. (20 .mu.g/ml) and 5-FU (100 .mu.g/ml).
[0067] FIG. 19 is bar graph showing the increased susceptibility of
biofilm-embedded S. epidermidis pretreated with DispersinB.TM. to
killing by sodium dodecyl sulfate (SDS). S. epidermidis growth was
measured in media with no antimicrobials (control), DispersinB.TM.
(20 .mu.g/ml), SDS (0.2 mg/ml), and a combination of DispersinB.TM.
(20 .mu.g/ml) and SDS (0.2 mg/ml).
[0068] FIG. 20 is bar graph showing the increased susceptibility of
biofilm-embedded S. epidermidis pretreated with DispersinB.TM. to
killing by chlorhexidine (CHX). S. epidermidis growth was measured
in media with no antimicrobials (control), DispersinB.TM. (20
.mu.g/ml), CHX (0.2 .mu.g/ml), and a combination of DispersinB.TM.
(20 .mu.g/ml) and CHX (0.2 .mu.g/ml).
[0069] FIG. 21 is bar graph showing the increased susceptibility of
biofilm-embedded S. epidermidis pretreated with DispersinB.TM. to
killing by benzalkonium chloride (BKC). S. epidermidis growth was
measured in media with no antimicrobials (control), DispersinB.TM.
(20 .mu.g/ml), BKC (0.4 .mu.g/ml), and a combination of
DispersinB.TM. (20 .mu.g/ml) and BKC (0.4 .mu.g/ml).
[0070] FIG. 22 is bar graph showing an enhanced inhibitory effect
of DispersinB.TM. and EDTA combination on S. epidermidis biofilm
formation. Planktonic (.quadrature.) and biofilm (.box-solid.) S.
epidermidis growth was measured in media with no antimicrobials
(control), DispersinB.TM. (100 ng/ml), EDTA (25 and 50 .mu.g/ml),
and combinations of DispersinB.TM. (100 ng/ml) and EDTA (25 or 50
.mu.g/ml).
[0071] FIG. 23 is bar graph showing the increased susceptibility of
biofilm-embedded S. epidermidis pretreated with DispersinB.TM. to
killing by silver nanopowder (SNP). S. epidermidis growth was
measured in media with no antimicrobials (control), DispersinB.TM.
(20 .mu.g/ml), SNP (0.03125 .mu.g/ml), and a combination of
DispersinB.TM. (20 .mu.g/ml) and SNP (0.03125 .mu.g/ml).
[0072] FIG. 24 is line graph showing the increased susceptibility
of biofilm-embedded E. coli csrA luxCDABE kan.sup.r over time to a
combination of DispersinB.TM. and a phage cocktail of FF3, K20, T7,
and U3 (.tangle-solidup.). Biofilm-embedded E. coli csrA luxCDABE
kan.sup.r grown in media without antimicrobials or DispersinB.TM.
was used as a control (.diamond.). Bio film-embedded E. coli csrA
luxCDABE kan.sup.r treated with DispersinB.TM. only (.box-solid.)
had growth similar to the control. Biofilm-embedded E. coli csrA
luxCDABE kan.sup.r were individually treated with phage FF3 (*),
K20 ( ), T7 CO, and U3 (-). Treatment with the phage produced a
short term decrease in E. coli metabolic activity, but the E. coli
metabolic activity returned to near control levels after 4 days.
Biofilm-embedded E. coli csrA luxCDABE kan.sup.r treated with a
phage cocktail of FF3, K20, T7, and U3 (X) alone produced similar
results as the treatments with the individual phages.
[0073] FIG. 25 is a schematic diagram of the construction of
recombinant .lamda. phage for DispersinB.TM. display.
[0074] FIG. 26 is a schematic diagram of the construction of
recombinant .lamda. phage for DispersinB.TM. display.
[0075] FIG. 27 is a schematic diagram of the construction of
recombinant M13 phage for DispersinB.TM. display.
[0076] FIG. 28 shows the biofilm growth and detachment of A.
actinomycetemcomitans strains CU1000 (wild-type) and HW1018 (PGA
mutant) in polystyrene tubes and 96-well microtiter plates. All
tubes and microplate wells were stained with crystal violet.
Biofilm formation at 0 h and 24 h in tubes (panel A) and
microplates (panel B). The biofilms on the right were rinsed with
water and treated with SDS (0.1% in PBS) or DispersinB.TM. (20
.mu.g/mL in PBS) for 5 rain prior to crystal violet staining. (C)
Detachment of CU1000 biofilms from microplates by SDS. Wells on the
bottom were pre-treated with DispersinB.TM. for 30 min prior to the
SDS treatment.
[0077] FIG. 29 is line graph showing the detachment of A.
actinomycetemcomitans strain CU1000 (wild-type) biofilms from
96-well microtiter plates by SDS. Biofilms were pre-treated with
PBS (mock pretreatment) or DispersinB.TM. (20 .mu.g/mL in PBS) for
30 min, and then treated with increasing concentrations of SDS for
5 min. Biofilms were then rinsed and stained with crystal violet.
We quantitated the amount of hound crystal violet dye, which is
proportional to biofilm biomass, by measuring its absorbance at 590
nm. Values are the mean absorbance for duplicate wells. Error bars
indicate range of standard deviation.
[0078] FIG. 30 is bar graph showing that pre-treatment of A.
actinomycetemcomitans CU1000 (wild-type) biofilms with
DispersinB.TM. increased sensitivity to killing by SDS. Biofilms
grown in polystyrene tubes were rinsed with PBS and treated with 1
mL of PBS (mock pre-treatment) or DispersinB.TM. (20 .mu.g/mL in
PBS) for 5 min (black bars) or 30 min (gray bars), and then treated
with PBS () or SDS (0.01% in PBS; +) for 5 min. Colony forming
units (CFU) were enumerated by dilution plating. Values indicate
the log 10 of the mean number of CFU per tube for duplicate tubes.
Error bars indicate range of standard deviation.
[0079] FIG. 31 is bar graph showing that pretreatment of A.
actinomycetemcomitans CU1000 biofilms with DispersinB.TM. increases
their sensitivity to killing by cetylpyridinium chloride (CPC).
Biofilms grown in polystyrene tubes were rinsed with PBS and
treated for 30 min with PBS (mock pretreatment) or PBS containing
20 .mu.g/mL of DispersinB.TM. B, and then treated for 5 min with
0.02% CPC. CFU were enumerated by dilution plating. Values indicate
the log 10 of the mean number of CFU/tube for duplicate tubes.
Error bars indicate range of standard deviation.
[0080] FIG. 32 is bar graph showing the effect of DispersinB.TM.
antimicrobial wound gel on Staphylococcus epidermidis growth and
biofilm formation.
[0081] FIG. 33 is a bar graph showing the effect of DispersinB.TM.
antimicrobial wound gel on Staphylococcus epidermidis biofilm
dispersal.
[0082] FIG. 34 is a bar graph showing the synergistic inhibitory
effect of DispersinB.TM. and Triclosan (TCSN) combination on
Staphylococcus epidermidis biofilm formation.
[0083] FIG. 35 is a bar graph showing the synergistic inhibitory
effect of DispersinB.TM. and Triclosan (TCSN) combination coated
silicone catheters on Escherichia coli colonization.
[0084] FIG. 36 is a bar graph showing the synergistic inhibitory
effect of DispersinB.TM. and Triclosan (TCSN) combination coated
silicone catheters on Staphylococcus epidermidis colonization
[0085] FIG. 37 is a bar graph showing the antibiofilm activity of
DispersinB.TM. and Triclosan (TCSN) combination-coated catheters
against catheter-associated microorganisms
[0086] FIG. 38 is a line graph showing the durability of inhibitory
activity of DispersinB.TM. and Triclosan (TCSN) combination-coated
polyurethane catheters.
[0087] FIG. 39 is a line graph showing the durability of inhibitory
activity of DispersinB.TM. and Triclosan (TCSN) combination-coated
polyurethane catheters in plasma (tested against Staphylococcus
epidermidis).
[0088] FIG. 40 a bar graph showing the durability of inhibitory
activity of DispersinB.TM. and Triclosan (TCSN) combination-coated
polyurethane catheters in TSB containing 20% Bovine Serum (tested
against Staphylococcus aureus).
[0089] FIG. 41 is a line graph showing the durability of inhibitory
activity of DispersinB.TM. and Triclosan (TCSN) combination-coated
polyurethane catheters in TSB containing 20% Bovine Serum (tested
against Staphylococcus aureus).
[0090] FIG. 42 is a line graph showing the inhibitory activity of
DispersinB.TM. and Triclosan (TCSN) combination coated silicone
catheters in synthetic urine (tested against Staphylococcus
aureus).
[0091] FIG. 43 is a line graph showing the durability of
DispersinB.TM. and Triclosan (TCSN) combination coated silicone
catheters in synthetic urine.
[0092] FIG. 44 is a bar graph showing the vivo efficacy of
DispersinB.TM. and Triclosan (TCSN) combination coated central
venous catheters.
[0093] FIG. 45 is a bar graph showing the effect of DispersinB.TM.
and xylitol alone and in combination on Staphylococcus epidermidis
biofilm formation.
[0094] FIG. 46 is a bar graph showing the effect of DispersinB.TM.
and glucose oxidase alone and in combination on Staphylococcus
epidermidis biofilm formation.
[0095] FIG. 47 is a bar graph showing the effect of DispersinB.TM.
and N-(1-pyrenyl)maleimide (PyrM) alone and in combination on
Staphylococcus epidermidis biofilm formation.
[0096] FIG. 48 is a bar graph showing the effect of DispersinB.TM.
and N,N-(1,2 phenylene)dimaleimide (oPDM), alone and in combination
on Staphylococcus epidermidis formation.
[0097] FIG. 49 is a bar graph showing the antibiofilm activity of
DispersinB.TM. and cefamandole nafate (CFN) combination-coated
catheters.
[0098] FIG. 50 is a bar graph showing the antibiofilm activity of
DispersinB.TM. and 5-fluorouracil (FU) combination-coated
catheters.
[0099] FIG. 51 is a bar graph showing the antibiofilm activity of
DispersinB.TM. and sodium usnate (SU) combination-coated
catheters.
[0100] FIG. 52 is a bar graph showing the antibiofilm activity of
DispersinB.TM. and benzalkonium chloride (BKC) combination-coated
catheters.
[0101] FIG. 53 is a bar graph showing the antibiofilm activity of
DispersinB.TM. and chitosan combination-coated catheters.
DETAILED DESCRIPTION
Definitions
[0102] The term "active fragment" refers to smaller portions of the
DispersinB.TM. polypeptide that retains the ability to disperse
bacteria or fungi.
[0103] The term "antimicrobial" means a compound or a composition
that kills or slows/stops the growth of microorganisms, including,
but not limited to bacteria and yeasts, and but not including
agents which specifically disperse bacteria or fungi. Some examples
of antimicrobials are triclosan, rifampicin, or cefamendole
nafate.
[0104] The term "biofilm embedded microorganisms" refers to any
microorganism that forms a biofilm during colonization and
proliferation on a surface, including, but not limited to,
gram-positive bacteria (e.g., Staphylococcus epidermidis),
gram-negative bacteria (e.g., Pseudomonas aeruginosa), and/or fungi
(e.g., Candida albicans).
[0105] The term "biofilm formation" means the attachment of
microorganisms to surfaces and the subsequent development multiple
layers of cells.
[0106] A "composition" refers to of this invention can comprise (a)
DispersinB.TM., an active fragment or variant thereof that
disperses a biofilm; and (b) an antimicrobial agent active against
bacteria or fungi, optionally in combination with a physiologically
acceptable carrier. The composition can further comprise an
additional antimicrobial agent.
[0107] The term "detergent" is used to mean any substance that
reduces the surface tension of water. A detergent may be a surface
active agent that concentrates at oil-water interfaces, exerts
emulsifying action and thereby aids in removing soils e.g., common
sodium soaps of fatty acids. A detergent may be anionic, cationic,
or monotonic depending on their mode of chemical action. Detergents
include linear alkyl sulfonates (LAS) often aided by "builders." A
LAS is preferably an alkyl benzene sulfonate ABS that is readily
decomposed by microorganisms (biodegradable). A LAS is generally a
straight chain alkyl comprising 10 to 30 carbon atoms. A detergent
may be in a liquid or a solid form.
[0108] A "viscosity increasing agent", "viscosity improving agent"
or "gelling agent" refers to agents that increase viscosity thereby
making compositions, such as wound gels, thick and stable. Examples
of a viscosity improving agents include, but are not limited to,
natural products such as alginic acid, sodium alginate, potassium
alginate, ammonium alginate, calcium alginate, agar, carrageenana,
locust bean gum, pectin, gelatine, carboxymethyl cellulose (CMC),
and chemically synthesized polymers, such as carbopol.
[0109] The term "disperse" or "disperse a biofilm" refers to
individual bacterial or fungal cells detaching from a surface or
detaching from a biofilm. The term "disperse" also refers to
disaggregation of autoaggregating bacterial or fungal biofilm
cells. "Disperses a biofilm" does not require all biofilm embedded
microorganisms to detach, but rather a portion to detach from a
surface or a biofilm.
[0110] The term "inhibition" or "inhibiting" refers to a decrease
of biofilm associated microorganism formation and/or growth. The
microorganisms can include bacteria (e.g., streptococci) or fungi
(e.g., Candida spp.)
[0111] "Modulating detachment" as used herein, is meant to be
inclusive of increases as well as decreases in bacterial or fungal
biofilm detachment or release of bacterial or fungal cells from a
biofilm. Further, "modulating detachment", is also meant to be
inclusive of changes in the ability of the bacteria or fungal to
attach as a biofilm. For example, as demonstrated herein,
DispersinB.TM. modulates detachment of S. epidermidis,
Staphylococcus aureus and Escherichia coli not only by promoting
detachment but also by inhibiting the ability of the bacteria to
attach to surfaces and form a biofilm.
[0112] The term "mammal" for purposes of treatment refers to any
animal classified as a mammal, including humans, domestic, farm,
sport and zoo animals, or pet animals, such as dogs, horses, cats,
cattle, pigs, sheep, etc. Preferably, the mammal is human.
[0113] The term "therapeutically effective amount" refers to an
amount of a composition of this invention effective to "alleviate"
or "treat" a disease or disorder in a subject or mammal. A
"therapeutically effective amount" as used herein includes a
prophylactic amount, for example, an amount effective for
preventing or protecting against infectious diseases, and symptoms
thereof, and amounts effective for alleviating or treating
infectious diseases, related diseases, and symptoms thereof. A
"therapeutically effective amount" as used herein also includes an
amount that is bacteriostatic or bacteriocidal, for example, an
amount effective for inhibiting growth of biofilm associated
bacteria or killing biofilm associated bacteria, respectively. A
"therapeutically effective amount" as used herein also includes an,
amount that is fungistatic or fungicidal, for example, an amount
effective for inhibiting further growth of biofilm associated fungi
or killing biofilm associated fungi, respectively. By administering
a DispersinB.TM. compound suitable for use in methods of the
invention concurrently with an antimicrobial compound, the
therapeutic antimicrobial compound may be administered in a dosage
amount that is less than the dosage amount required when the
therapeutic antimicrobial compound is administered as a sole active
ingredient. By administering lower dosage amounts or the active
ingredient, the side effects associated therewith should
accordingly be reduced.
[0114] The term "treatment", "treating", or "alleviating" refers to
an intervention performed with the intention of preventing the
development or altering the pathology of a disorder. Accordingly,
"treatment" refers to both therapeutic treatment and prophylactic
or preventative measures. Those in need of treatment include those
already with the disorder as well as those in which the disorder is
to be prevented.
[0115] A chronic wound defined herein is a wound that fails to
progress through an orderly and timely sequence of repair or a
wound that docs not respond to treatment and/or the demands of
treatment are beyond the patient's physical health, tolerance or
stamina. Many wounds that are first considered to be acute wounds
ultimately become chronic wounds due to factors still not well
understood. One significant factor is the transition of planktonic
bacteria within the wound to form a biofilm.
[0116] In the context of wound treatment, "biofilm disruption" or
"inhibition of biofilm reconstitution" refers to biofilm clearance
from a chronic or acute wound, or to inhibit reconstitution of a
biofilm mass from remnants remaining after debridement and thereby
promote healing of a wound.
[0117] A "wild type" or "reference" sequence or the sequence of a
"wild type" or "reference" protein/polypeptide, such as a coat
protein, or a CDR or variable domain of a source antibody, maybe
the reference sequence from which variant polypeptides are derived
through the introduction of mutations. In general, the "wild type"
sequence for a given protein is the sequence that is most common in
nature. Similarly, a "wild type" gene sequence is the sequence for
that gene which is most commonly found in nature. Mutations may be
introduced into a "wild type" gene (and thus the protein it
encodes) either through natural processes or through man induced
means. The products of such processes are "variant" or "mutant"
forms of the original "wild type" protein or gene.
[0118] A "variant" of a polypeptide refers to a polypeptide that
contains an amino acid sequence that differs from a wild type or
reference sequence. A variant polypeptide can differ from the wild
type or reference sequence due to a deletion, insertion, or
substitution of a nucleotide(s) relative to said reference or wild
type nucleotide sequence. The reference or wild type sequence can
be a full-length native polypeptide sequence or any other fragment
of a full-length polypeptide sequence. A polypeptide variant
generally has at least about 80% amino acid sequence identity with
the reference sequence, but may include 85% amino acid sequence
identity with the reference sequence, 86% amino acid sequence
identity with the reference sequence, 87% amino acid sequence
identity with the reference sequence, 88% amino acid sequence
identity with the reference sequence, 89% amino acid sequence
identity with the reference sequence, 90% amino acid sequence
identity with the reference sequence, 91% amino acid sequence
identity with the reference sequence, 92% amino acid sequence
identity with the reference sequence, 93% amino acid sequence
identity with the reference sequence, 94% amino acid sequence
identity with the reference sequence, 95% amino acid sequence
identity with the reference sequence, 96% amino acid sequence
identity with the reference sequence, 97% amino acid sequence
identity with the reference sequence, 98% amino acid sequence
identity with the reference sequence, 98.5% amino acid sequence
identity with the reference sequence, 99% amino acid sequence
identity with the reference sequence, or 99.5% amino acid sequence
identity with the reference sequence.
[0119] "Percent (%) nucleic acid sequence identity" is defined as
the percentage of nucleotides in a candidate sequence that are
identical with the nucleotides in a reference polypeptide-encoding
nucleic acid sequence, after aligning the sequences and introducing
gaps, if necessary, to achieve the maximum percent sequence
identity. Alignment for purposes of determining percent nucleic
acid sequence identity can be achieved in various ways that are
within the skill in the art, for instance, using publicly available
computer software such as BLAST, BLAST-2, ALIGN, ALIGN-2 or
Megalign (DNASTAR) software. Appropriate parameters for measuring
alignment, including any algorithms needed to achieve maximal
alignment over the full-length of the sequences being compared can
be determined by known methods.
[0120] For purposes herein, the % nucleic acid sequence identity of
a given nucleic acid sequence C to, with, or against a given
nucleic acid sequence D (which can alternatively be phrased as a
given nucleic acid sequence C that has or comprises a certain %
nucleic acid sequence identity to, with, or against a given nucleic
acid sequence D) is calculated as follows: [0121] 100 times the
fraction W/Z, where W is the number of nucleotides scored as
identical matches by the sequence alignment program in that
program's alignment of C and D, and where Z is the total number of
nucleotides in D. Where the length of nucleic acid sequence C is
not equal to the length of nucleic acid sequence D, the % nucleic
acid sequence identity of C to D will not equal the % nucleic acid
sequence identity of D to C.
[0122] The term "protein" has an amino acid sequence that is longer
than a peptide. A "peptide" contains 2 to about 50 amino acid
residues. The term "polypeptide" includes proteins and peptides.
Examples of proteins include, but are not limited to, antibodies,
enzymes, lectins and receptors; lipoproteins and lipopolypeptides;
and glycoproteins and glycopolypeptides.
[0123] A "phage coat protein" comprises at least a portion of the
surface of the phase virus particle. Functionally, a coat protein
is any protein that associates with a virus particle during the
viral assembly process in a host cell and remains associated with
the assembled virus until infection. A major coat protein is that
which principally comprises the coat and is present in 10 copies or
more copies/particle; a minor coat protein is less abundant. A
phage coat protein may be a variant coat protein. Some variant coat
proteins have improved display of the fused polypeptide.
[0124] A "fusion protein" and a "fusion polypeptide" refer to a
polypeptide having two portions covalently linked together, where
each of the portions is a polypeptide having a different property.
The property may be a biological property, such as activity in
vitro or in vivo. The property may also be a simple chemical or
physical property, such as binding to target antigen, catalysis of
a reaction, etc. The two portions may be linked directly by a
single peptide bond or through a peptide linker containing one or
more amino acid residues. Generally, the two portions and die
linker will be in reading frame with each other. Preferably, the
two portions of the polypeptide are obtained from heterologous or
different polypeptides.
[0125] The term "phage display" is a technique by which
polypeptides are displayed as fusion proteins to at least a portion
of coat protein on the surface of phage, e.g., filamentous phage,
particles. A utility of phage display lies in the fact that large
libraries of randomized protein variants can be rapidly and
efficiently sorted for those sequences that bind to a target
antigen with high affinity. Display of peptide and protein
libraries on phage has been used for screening millions of
polypeptides for ones with specific binding properties. Polyvalent
phage display methods have been used for displaying small random
peptides and small proteins through fusions to either gene III or
gene VIII of filamentous phage (Wells & Lowman, Curr. Opin.
Struct. Biol., 3:355-362 (1992)).
[0126] "PCR" refers to the technique in which minute amounts of a
specific piece of nucleic acid, RNA and/or DNA, are amplified as
described in U.S. Pat. No. 4,683,195. PCR can be used to amplify
specific RNA sequences, specific DNA sequences from total genomic
DNA, and cDNA transcribed from total cellular RNA, bacteriophage or
plasmid sequences, etc.
[0127] DNA is "purified" when the DNA is separated from non-nucleic
acid impurities. The impurities may be polar, non-polar, ionic,
etc.
[0128] The term "nucleic acid" as used herein includes (but is not
limited to) unmodified RNA or DNA or modified RNA or DNA. Thus, by
nucleic acid it is meant to be inclusive of single- and
double-stranded DNA, DNA that is a mixture of single- and
double-stranded regions, single- and double-stranded RNA, and RNA
that is a mixture of single- and double-stranded regions, hybrid
molecules containing DNA and RNA that may be single-stranded or,
more typically, double-stranded or a mixture of single- and
double-stranded regions. Further, the DNA or RNA sequences of the
present invention may comprise a modified backbone and/or modified
bases. A variety of modifications to DNA and RNA are known in the
art for multiple useful purposes. The term "nucleic acid" as it is
employed herein embraces such chemically, enzymatically or
metabolically modified forms of nucleic acids, as well as the
chemical forms of DNA and RNA characteristic of viruses and cells,
including simple and complex cells.
[0129] By the term "allelic variant" as used herein it is meant one
of two or more alternative naturally occurring forms of a gene,
each of which comprises a unique nucleic acid sequence. Allelic
variants encompassed by the present invention encode proteins with
similar or identical enzymatic activities.
DispersinB.TM.
[0130] Biofilm-embedded Aggregatibacter (Formerly Actinobacillus)
actinomycetemcomitans can release individual cells into liquid
medium. These detached cells can attach to the surface of a culture
apparatus and start a new colony. The dspB gene encodes a 381 amino
acid soluble .beta.-N-acetylglucosaminidase that is responsible for
the detachment/dispersion of A. actinomycetemcomitans. This
polypeptide is referred to as DispersinB.TM.. The first 20 amino
acids are a signal peptide, and amino acids 21-381 are the mature
polypeptide. The mature DispersinB.TM. polypeptide has the
following sequence (SEQ ID NO:11; Accession No. AY228551.1):
TABLE-US-00001 1 nccvkgnsiy pqktstkqtg lmldiarhfy speviksfid
tislsggnfl hlhfsdheny 61 aieshllnqr aenavqgkdg iyinpytgkp
flsyrqlddi kayakakgie lipeldspnh 121 mtaifklvqk drgvkylqgl
ksrqvddeid itnadsitfm qslmsevidi fgdtsqhfhi 181 ggdefgysve
snhefityan klsyfiekkg lktrmwndgl ikntfeqinp nieitywsyd 241
gdtqdkneaa errdmrvslp ellakgftvl nynsyylyiv pkasptfsqd aafaakdvik
301 nwdlgvwdgr ntknrvqnth eiagaalsiw gedakalkde tiqkntksll
eavihktngd 361 e
The closely related Actinobacillus pleuropneumoniae also encodes a
DispersinB.TM., which is a 377 amino acid polypeptide that includes
a signal peptide from amino acids 1 to 34. The A. pleuropneumoniae
DispersinB.TM. has the following full polypeptide sequence (SEQ ID
NO:12; Accession No. AY618481.1; AAT46094.1 GI:48727581):
TABLE-US-00002 1 mkkaitlftl lcavllsfst atyanamdlp kkesgltldi
arrfytvdti kgfidtihqa 61 ggtflhlhfs dhenyaless yleqreenat
ekngtyfnpk tnkpfltykq lneiiyyake 121 rnieivpevd spnhmtaifd
lltlkhgkey vkglkspyia eeidinnpea veviktlige 181 viyifghssr
hfhiggdefs yavennhefi ryvntlndfi nskglitrvw ndglthnnls 241
elnknieity wsydgdaqak edigyrreir adlpellang fkvinynsyy lyfvpksgsn
301 ihndgkyaae dvlnnwtlgk wdgknssnhv qntqniigss lsiwgerssa
lneqtiqqas 361 knllkaviqk tndpksh
[0131] Embodiments of the invention also include active fragments
and variants of SEQ ID No:11 and SEQ ID No:12. DispersinB.TM.
active fragments and variants only include those fragments and
variants that retain an ability to disperse a bacterial or fungal
cell from a biofilm.
[0132] A substrate for both DispersinB.TM. is a high-molecular
weight hexosamine-containing extracellular polysaccharide adhesin
encoded in the pgaABCD locus and pgaCD in A. actinomycetemcomitans
and A. pleuropneumoniae, respectively (Kaplan et al., 2004, J.
Bacteriol. 186:8213-8220). These polysaccharide adhesins are a
component of the Aggregatibacter biofilm. A PGA component of the
biofilm functions as a protective barrier for cells of a biofilm.
Aggregatibacter PGA is structurally and functionally similar to E.
coli PGA and S. epidermidis PTA, both polysaccharides comprising
N-acetyl-D-glucosamine residues in a .beta.(1,6) linkage (Kaplan et
al., 2004). Thus, embodiments of this invention can be used to
detach bacterial cells other than A. actinomycetemcomitans or A.
pleuropneumoniae.
[0133] Nucleic acid sequences encoding orthologs of DispersinB.TM.
protein have been identified in A. lingniersii strain. 19393, A.
actinomycetemcomitans strain IDH 781, Haemophilus aphrophilus
strain NJ8700 and A. pleuropneumoniae Strain IA5 and are depicted
in SEQ ID No: 3, 5, 7, and 9, respectively. Accordingly, preferred
isolated nucleic acid sequences of the present invention comprise
SEQ TD No. 1, 3, 5, 7 or 9.
[0134] Also included within the present invention are allelic
variants of the exemplified DispersinB.TM. nucleic acid sequence
for SEQ ID No: 1, 3, 5, 7, or 9 encoding proteins with similar
enzymatic activities to DispersinB.TM. and nucleic acid sequences
with substantial percent sequence identity to the exemplified
DispersinB.TM. nucleic acid sequences of SEQ ID NO: 1, 3, 5, 7 or 9
encoding proteins with similar enzymatic activities
[0135] There are similarities between the amino acid sequence of
DispersinB.TM. and these orthologs and the consensus sequence of
the Family 20 glycosyl hydrolase. More specifically, amino acid
residues 40 to 297 of the predicted DispersinB.TM. protein sequence
are homologous to the catalytic domain of the family 20 glycosyl
hydrolases (NCBI Conserved Domain Database accession Number
pfam00728). This family of enzymes includes bacterial chitinases,
chitobiases and lacto-N-biosidases (Sano et al. J. Biol. Chem. 1993
268:18560-18566; Tews et al. Gene 1996, 170:63-67; Tstijibo et al.
Biochim. Biophys. Acta 1998, 1425:437-440.), and eukaryotic
hexosaminidases (Graham et al. J. Biol. Chem. 1988
263:16323-16329). A protein related to A. actinomycetemcomitans
DispersinB.TM. is lacto-N-biosidase or Lactococcus lactis (GenBank
accession no. AAK05592), which displays 28% identity over 281 amino
acid residues not counting gaps and terminal extensions.
[0136] Similarity between DispersinB.TM. and lacto-N-biocidases is
high in the regions surrounding Arg47 and the acidic amino acid
pair Asp202 and Glu203. These residues have been shown to
participate in substrate binding and catalysis in other family 20
glycosyl hydrolases (Mark et al. J. Biol. Chem. 2001,
276:10330-10337; Mark et al. J. Biol. Chem. 1998, 273:19618-19(124;
Prag et al. J. Mol. Biol. 2000, 300:611-617). The C-terminal half
of DispersinB.TM. contained three Trp residues that were conserved
in L. lactis facto-N-biosidase (positions 236, 279, and 353).
Multiple Trp residues are present in the C-terminal regions of the
catalytic domains of all family 20 glycosyl hydrolases (Graham et
al. J. Biol. Chem. 1988, 263:16823-16829; Tews et al. Gene 1996,
170:63-67). These Trp residues line the part of the substrate
binding pocket that is complementary to the hydrophobic surfaces of
the hexosamine sugar ring (Tews et al. Nature Struct. Biol. 1996,
3638-648). It is expected that mutation of amino acids in these
regions of DispersinB.TM. and its orthologs will alter enzymatic
activity.
[0137] In a preferred embodiment an isolated amino acid sequence of
the present invention comprises SEQ ID NO: 2, 4, 6, 8, 10, 11 or 12
or an active fragment or variants thereof. Preferred active
fragments are those comprising a portion of the amino acid sequence
of SEQ ID NO: 2, 4, 6, 8, 10, 11 or 12 with similarities to the
consensus sequence of the family 20 glycosyl hydrolase.
[0138] "Active variants or "functionally equivalent variants" as
used herein are polypeptide sequences structurally different from
the DispersinB.TM. protein, but having no significant functional
difference from the protein. For example, when orthologous
polypeptide sequences front various strains or A.
actinomycetemcomitans are aligned, divergence in amino acid
sequence is observed, usually 0 to 10 percent (Kaplan et al. Oral
Microbiol. Immunol. December 2002, 17:354-359; Kaplan et al.
Infect. Immun. 2001, 69:5375-5384). Proteins displaying this amount
of divergence are considered functionally equivalent variants
because of the fact that mixing of genetic alleles that encode
these variants is often observed in populations (Kaplan et al. Oral
Microbol. Immunol. December, 2002 17:354-359). The DispersinB.TM.
sequence from A. actinomycetemcomitans strain IDH781 (SEQ ID NO:6),
therefore, is expected to be a functionally equivalent or active
variant of SEQ ID NO:2, and is included in the scope of the present
invention. Similarly, DispersinB.TM. sequences from other strains
of A. actinomycetemcomitans, such as those that exhibit different
serotypes, restriction fragment length polymorphism genotypes, 16S
ribosomal RNA genotypes, or arbitrarily-primed PCR genotypes that
are commonly observed among phylogenetically diverse strains 35
isolated from different subjects (Kaplan et al. J. Clin. Microbiol.
2002 40:1181-1187; Kaplan et al., Oral Microbiol. Immunol. December
2002 17:354.359), are also expected to be functionally equivalent
or active variants of SEQ ID NO:2, and are included in the scope of
the present invention.
[0139] Similarly, orthologous proteins from phylogenetically
diverse species of bacteria are usually functionally equivalent or
active variants, as evidenced by the fact that a common method for
cloning genes of interest into plasmids is to screen a plasmid
library for plasmids that complement a genetic mutation in a
different species of bacteria (Kaplan et al. J. Mol. Biol. 1985
183:327-340). This is especially true of bacterial enzymes.
Orthologous enzymes of different bacterial species can exhibit up
to 50% divergence or greater, yet still utilize the identical
substrate, catalyze the same chemical reaction, and produce the
same product. This sequence divergence results from genetic drift
coupled with fixation of selected genetic changes in the
population. The genetic changes that are selected and fixed are
those that alter characteristics of the enzyme other than
substrate, reaction, and product, as for example, reaction rate, pH
optimum, temperature optimum, level of expression, and interactions
with other enzymes, such that these genetic changes confer upon a
bacterial cell a selective advantage in its environment. Since A.
actinomycetemcomitans is genetically closely related to A.
pleuropneumoniae (Dewhirst et al. J. Bacteriol. 1992 174:2002-2013)
and produces a biofilm similar to that produced by A.
actinomycetemcomitans, which detaches upon contact with A.
actinomycetemcomitans DispersinB.TM., it is expected that the A.
pleuropneumoniae DispersinB.TM. homologue identified in SEQ ID
NO:10 is a functionally equivalent or active variant of SEQ ID
NO:2, and is included in the scope of the present invention,
Similarly, since Actinobacillus lignieresii is genetically closely
related to Actinobacillus pleuropneumoniae (Dewhirst et al. J.
Bacteriol. 1992 174:2002-2013) and Haemophilus aphrophilus is
genetically closely related to A. actinomycetemcomitans (Dewhirst
et al. J. Bacteriol. 1992 174:2002-2013; Kaplan et al. J. Clin.
Microbiol. 2002 40:1181-1187), and since both A. lignieresii and
Haemophilus aphrophilus produce biofilms similar to that produced
by A. actinomycetemcomitans, it is expected that the Actinobacillus
lignieresii and Haemophilus aphrophilus DispersinB.TM. homologues
identified in SEQ ID NO:4 and SEQ ID NO:5, respectively, are
functionally equivalent or active variants of SEQ ID NO:2, and are
included in the scope of the present invention.
[0140] The above mentioned examples demonstrate functionally
equivalent or active variants of A. actinomycetemcomitans
DispersinB.TM. that occur in nature. As will be understood by those
of skill in the art upon reading this disclosure, however,
artificially produced genes that encode functionally equivalent or
active variants of A. actinomycetemcomitans DispersinB.TM. can also
be produced routinely in accordance with the teachings herein using
various well known genetic engineering techniques. For example, a
genetically engineered dispersin enzyme that lacks 20 N-terminal
amino acid residues, and also contained a 32 amino acid residue
C-terminal tail, which it functionally equivalent to the natural
DispersinB.TM. enzyme has been produced. It has also been shown
that the methionine residue at the N-terminus of this genetically
engineered DispersinB.TM. enzyme, when expressed in E. coli, was
removed by the action of methionine aminopeptidase, yet the absence
of the methionine did not affect enzyme activity. It has also been
shown that cleavage of the C-terminal 28 amino acid residues from
this genetically engineered DispersinB.TM. enzyme has no affect on
enzyme activity. These examples demonstrate that artificial genes
can be produced that encode functionally equivalent variants of A.
actinomycetemcomitans DispersinB.TM.. These artificially produced
functionally equivalent variants of A. actinomycetemcomitans
DispersinB.TM. are included in the scope of the present
invention.
[0141] The above mentioned examples demonstrate
genetically-engineered, functionally equivalent variants of A.
actinomycetemcomitans DispersinB.TM. that contain either a deletion
of amino acid residues at the N-terminus of the protein, or the
fusion of an additional polypeptide at the C-terminus of the
protein. It is expected that other genetically-engineered
alterations, such as the fusion of an additional polypeptide at the
N-terminus at the protein, a deletion of amino acid residues at the
C-terminus of the protein, internal deletions and insertions of
amino acid residues, and amino acid substitutions, would also
result in functionally equivalent variants of A.
actinomycetemcomitans DispersinB.TM.. Information about which
deletions, insertions, and amino acid substitutions would produce
functionally equivalent variants of A. actinomycetemcomitans
DispersinB.TM. can be obtained from amino acid sequence alignments,
and from commonly available computer software that predicts
polypeptide secondary structures based on both primary amino acid
sequences and on amino acid sequence alignments with homologous
proteins having known three-dimensional structures. A.
actinomycetemcomitans DispersinB.TM., for example, is a member of
the family 20 glycosyl hydrolases, a family that includes several
well-studied enzymes, and a family represented by numerous
homologous primary amino acid sequences in the public databases. In
some cases, three-dimensional structures of family 20 glycosyl
hydrolases are known (Tews et al. Nature Struct. Biol. 1996
3:638-648).
[0142] All family 20 glycosyl hydrolases exhibit a
(.alpha..beta.).sub.8-barrel motif (also known as a TIM-barrel
motif; Tews et al. Nature Struct. Biol. 1996 3:638-648; Prag et al.
J. Mol. Biol. 2000 300:611-617), which is by far the most common
enzyme fold in the Protein Data Bank (PDB) database of known
protein structures. It is estimated that 10% of all known enzymes
have this domain (Wierenge, R. K., FEBS Lett. 2001 492:193-198).
The (.alpha..beta.).sub.8-barrel motif is seen in many different
enzyme families, catalyzing completely unrelated reactions. The
availability of numerous homologous primary amino acid sequences,
combined with the availability of the three-dimensional structures
of several A. actinomycetemcomitans DispersinB.TM. homologues,
forms the basis of these sequence alignments and secondary
structure predictions. For example, the
(.alpha..beta.).sub.8-barrel motif consists of eight
.alpha.-helices and eight .beta.-strands such that eight parallel
.beta.-strands form a barrel on the inside of the protein, which
are covered by eight .alpha.-helices on the outside of the protein.
Based on the above mentioned protein sequence alignments and
structural predictions, it is expected that the eight
.beta.-strands in A. actinomycetemcomitans DispersinB.TM. comprise
the amino acid residues surrounding positions 41-44, 69-81,
130-134, 169-171, 189-200, 253-256, 288-300, and 348-360 of SEQ ID
NO:2. Any alteration in the amino acid sequence that disrupts the
.beta.-strand architecture of these eight regions would be expected
to result in a decrease in enzyme activity because of a concomitant
disruption in the three-dimensional structure of the
(.alpha..beta.).sub.8-barrel of the enzyme. Similarly, based on the
above mentioned protein sequence alignments and structural
predictions, it is expected that the eight a-helices in A.
actinomycetemcomitans DispersinB.TM. comprise the amino acid
residues surrounding positions 52-63, 89-93, 143-149, 176-183,
214-228 269-284, 309-321, and 361-374 of SEQ ID NO:2. Any
alteration in the amino acid sequence that disrupts the
.beta.-helical architecture of these eight regions would be
expected to result in a decrease in enzyme activity because of a
concomitant disruption in the three-dimensional structure of
(.alpha..beta.).sub.8-barrel of the enzyme.
[0143] Similarly, because the .alpha.-strands consist of four
inward pointing side chains (pointing into the
(.alpha..beta.).sub.8-barrel) and four outward pointing side chains
(pointing towards the .alpha.-helices), it is expected that
alterations in the inward-pointing amino acid residues will reduce
enzyme activity because of concomitant alterations to the substrate
binding pocket inside the (.alpha..beta.).sub.8-barrel, and that
alterations in the outward-pointing amino acid residues will reduce
enzyme activity when they interfere with the interactions, between
the .beta.-strands and the .alpha.-helices. Similarly, the active
site of family 20 glycosyl hydrolases is always located at the
C-terminal end of the eight parallel .beta.-strands of the barrel.
It is expected that alterations in the homologous region of A.
actinomycetemcomitans DispersinB.TM. will affect enzyme activity.
Similarly, it is predicted that the introduction of insertions and
deletions into the regions between the .alpha.-helices and the
.beta.-strands, namely in positions 45-51, 64-68, 82-88, 94-129,
135-142, 150-168, 172-175, 182-188, 201-213, 229-252, 257-268,
285-287, 301-308, 322-347, and 351-360, in SEQ ID NO:2, will not
effect enzyme activity. Similarly, it is expected that almost any
alteration of residues 47 (Arginine), 203 (Aspartate) and 204
(Glutamate) will result in complete loss of enzyme activity,
because these three residues have been shown to participate
directly in substrate binding and catalysis in all family 20
glycosyl hydrolases (Mark et al. J. Biol. Chem. 1998 273:
19618-19624; Prag et al. J. Mol. Biol. 2000, 300:611-617; Mark et
al. Biol. Chem. 2001 276:10330-10337). Similarly, it is expected
that alteration of the three tryptophan residues at positions 236,
257 and 350, to any non-aromatic amino acid residue will result in
a decrease in enzyme activity because these three tryptophan
residues have been shown to line part or the substrate-binding
pocket that is complementary to the hydrophobic surfaces of the
substrate hexosamine sugar ring (Tews et al. Nature Struct. Biol.
1996 3:638-648). As a result of the locations of these essential
amino acid residues in A. actinomycetemcomitans DispersinB.TM., it
is predicted that no more than 46 amino acid residues can be
deleted from the N-terminus, and no more that 31 amino acids can be
deleted from the C-terminus, without loss of enzyme activity. All
of those genetic alterations that result in functionally equivalent
variants are included in the scope of the present invention.
[0144] Genes encoding functionally different variants of A.
actinomycetemcomitans DispersinB.TM. can also be produced in
accordance with the teachings of the instant application using well
known genetic engineering techniques. For example, as mentioned
above, it is expected that almost any alteration of residues 47
(Arginine), 203 (Aspartate) and 204 (Glutamate) in SEQ ID NO:2 will
result in complete loss of enzyme activity. Alternatively, variants
of A. actinomycetemcomitans DispersinB.TM. that exhibit
characteristics that may be useful in a clinical setting could also
be artificially produced. For example, the temperature optimum of
A. actinomycetemcomitans DispersinB.TM. is 30.degree. C. It may be
desirable to produce a genetically-engineered variant of
DispersinB.TM. that exhibits a temperature optimum of 37.degree.
C., thereby resulting in an increased effectiveness of the enzyme
or decreased cost of treatment, such variants can be artificially
produced by first creating random mutations in the A.
actinomycetemcomitans DispersinB.TM. gene sequence, for example by
using UV light or a chemical mutagen like nitrosoguanidine and then
screening large numbers of these random variants, for example in a
quantitative 96-well microtiter plate assay (Kaplan et al. J.
Bacteriol. 2003 185:4693-4698), for ones that exhibit higher
temperature optima. An alternative method is to utilize directed
evolution of sequences by DNA shuffling (Christians et al. Nature
Biotechnol. 1999 17:259-264; Dichek et al. J. Lipid Res. 1993
34:1393-1340), combined with a high-throughput robotic screen based
upon a quantitative 96-well microtiter plate assay (Kaplan et al.
J. Bacteriol. 2003 18S:4693-4698) to identify variants with
increased temperature optima. The aforementioned methods can also
be used to produce variants of A. actinomycetemcomitans
DispersinB.TM. that exhibit increased substantivity to
biomaterials, increased pH optima, increased stability in aqueous
solutions, increased reaction rate, increased stability upon
desiccation, and other characteristics that could result in
increased effectiveness of the enzyme or decreased cost of
treatment. An alternative method that can be used to produce useful
variants is site-directed mutagenesis. For example, it is expected
that the eight .alpha.-helices of the (.alpha..beta.).sub.8-barrel
in A. actinomycetemcomitans DispersinB.TM. contain many amino acid
residues that are exposed on the outer surface of the enzyme, and
that altering the outward-pointing amino acid residues of the eight
.alpha.-helices will alter the outer surface properties of the
enzyme, thereby potentially increasing the substantivity oldie
enzyme for biomaterials without affecting enzyme activity.
Accordingly, these outward painting amino acid residues can be
systematically mutated, for example from polar residues to charged
residues, and the resulting mutants screened to identify variants
with increased substantivity to biomaterials. Functionally
different variants of A. actinomycetemcomitans DispersinB.TM. that
are intended to improve the clinical efficiency or cost
effectiveness of the enzyme, when applied to detaching bacterial or
fungal cells from biofilms, are included in the scope of the
present invention.
Compositions
[0145] Antibiofilm enzyme-based antimicrobial compositions
comprising DispersinB.TM. or an active fragment or variant thereof,
and an antimicrobial agent, can inhibit biofilm formation as well
as biofilm growth. In particular, a composition comprising
DispersinB.TM. or an active fragment or variant thereof, and
triclosan, a broad-spectrum antimicrobial has enhanced antibiofilm
and antimicrobial activity. Such compounds are effective for
inhibiting growth and proliferation biofilm-embedded
microorganisms, including both bacterial and fungal species. An
enhanced antimicrobial activity of antimicrobials used in
combination with DispersinB.TM. enzyme is evidenced by the low
concentration of each compound required to inhibit bacterial growth
effectively. In particular, it is possible to use small amounts of
DispersinB.TM., or an active fragment or variant thereof, which are
biologically acceptable, and a small amount of triclosan, which is
biologically acceptable at lower concentrations.
[0146] It will be appreciated that DispersinB.TM. or active
fragments or variants thereof and antimicrobial agents can be used
together in the form of a single composition in one embodiment or
together in the form of separate compositions tier inhibiting
growth and proliferation of biofilm-embedded microorganisms in
another embodiment. In embodiments wherein separate compositions
comprising DispersinB.TM. or an active fragment or variant thereof
and antimicrobial agents are employed, the separate compositions
can be used at the same time or sequentially. In a preferred
embodiment, a composition comprising DispersinB.TM. or an active
fragment or variant thereof is administered separately to a bio
film to be treated followed by separate administration of a
composition comprising an antimicrobial agent for inhibiting growth
and proliferation of biofilm-embedded microorganisms. In a further
preferred embodiment, the composition comprising an antimicrobial
agent, comprises sodium doceyl sulfate, benzalkonium chloride or
chlorhexidine as the antimicrobial agent.
[0147] Accordingly, an embodiment of the present invention provides
compositions for preventing growth and proliferation of biofilm
embedded-microorganisms comprising: (a) DispersinB.TM., an active
fragment, or variant thereof; and (b) triclosan.
[0148] Also, other antimicrobials including, but not limited to,
triclosan, antibiotics (such as rifampicin, cefamandole nafate and
ciprofloxacin) nitrofurazone, bismuth-thiols [such as bismuth
ethanedithiol BisEDT)], chitosan, epigallocatechin gallate (EGCG),
sodium usnate, antineoplastic agents (such as 5-fluorouracil),
detergents (such as sodium doceyl sulfate (SDS), benzalkonium
chloride), chlorhexidine, chelating agents (such as EDTA), silver
compounds, bacteriophage, antimicrobial enzymes (such as glucose
oxidase and lactoperoxidase), sugar alcohols (such as xylitol),
maleimides [such as N,N-(1,2 phenylene) dimaleimide (oPDM) and
N-(1-pyrenyl) maleimide (PyrM)], cadexomer iodine, methylene blue,
gentian violet, medium chain dextrans (such as honey), and mixtures
thereof can be used in combination with DispersinB.TM..
[0149] An enhanced antimicrobial composition of the invention
requires remarkably small amounts of active ingredients (compared
to that used in the past) to be effective against the microbial
growth and biofilm formation. A composition according to the
invention may have properties that include those of separate
compounds but go beyond them in efficacy and scope of application.
Extremely low levels, and hence increased efficacy, of active
compounds or ingredients, make embodiments of this invention very
desirable and relatively economical to manufacture, although higher
concentrations of these compounds can be used jilt is desired for
certain applications. A further advantage of using these
compositions is the effectiveness for preventing growth of biofilm
embedded bacteria and fungus, and in particular, bacterial and
fungal species that colonize wounds.
[0150] DispersinB.TM.-based antimicrobial compositions of the
invention can be used to inhibit the proliferation of
biofilm-embedded gram-negative and grain-positive bacteria, which
include, but are not limited to: Escherichia coli, Proteus
mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa,
Klebsiella oxytoca, Providentia stuartii, Serratia marcescens,
Enterococcus faecalis, Vancomycin Resistant Enterococci (VRE),
Peptostreptococcus spp., Corynebacterium spp., Clostridium spp.,
Bacteroides spp., Prevotella spp., Streptococcus pyogenes,
Streptococcus viridans, Micrococcus spp., .beta.-hemolytic
streptococcus (group C), Beta-hemolytic streptococcus (group B),
Bacillus spp., Porphyromonas spp., Aggregatibacter
actinomycetemcomitans, Fusobacterium nucleatum, Treponema
denticola, Staphylococcus epidermidis, Staphylococcus aureus and
Staphylococcus saprophyticus.
[0151] Additionally, DispersinB.TM.-based antimicrobial
compositions of the invention can also be used to inhibit the
proliferation of biofilm-embedded fungi, such as Candida albicans,
Candida parapsilosis, and Candida utilis.
[0152] In one aspect, a DispersinB.TM.-based antimicrobial
composition can treat various kinds of wounds, including, but not
limited to, cutaneous abscesses, surgical wounds, sutured
lacerations, contaminated lacerations, blister wounds, soft tissue
wounds, partial thickness and full thickness burns, decubitus
ulcers, stasis ulcers, leg ulcers, foot ulcers, venous ulcers,
diabetic ulcers, ischemic ulcers, and pressure ulcers
[0153] Another aspect includes methods of using
DispersinB.TM.-based antimicrobial compositions in wound care
devices including, but not limited to, non-resorbable gauze/sponge
dressing, hydrophilic wound dressing, occlusive wound dressing,
hydrogel wound and burn dressing, spray-applicator, and also in
ointments, lotions, and suture.
[0154] Suitable substrates for receiving a topically applied
DispersinB.TM.-based antimicrobial composition finish include,
without limitation, fibres, fabrics, and alginates. A fabric may be
formed from fibres such as synthetic fibres, natural fibres, or a
combination thereof. Synthetic fibres include, for example,
polyester, acrylic, polyamide, polyolefin, polyaramid,
polyurethane, regenerated cellulose (i.e., rayon), and blends
thereof. Suitable polymeric materials include but are not limited
to silastic or other silicone-based material,
polyethylenetecephtalate (PET), Dacron.RTM., knitted Dacron.RTM.,
velour Dacron.RTM., polyglacin, chromic gut, nylon, silk, bovine
arterial graft, polyethylene (PE), polyurethane, polyvinyl
chlorides silastic elastomer, silicone rubber, PMMA
[poly-(methylmethacrylate), latex, polypropylene (PP), polyolefin,
cellulose, poly vinyl] alcohol (PVA), poly(hydroxyethyl
methacrylate (PHEMA), poly(glycolic acid), poly (acrylonitrate)
(PAN), fluoroethylene-cohexa-fluoropropylene (FEP), Teflon.RTM.
(PTFE), Cobalt-Cromium alloys, copolymers thereof and mixtures
thereof.
[0155] A method of incorporating a therapeutically active
DispersinB.TM.-based composition of the present invention into the
polymeric material includes direct compounding of a therapeutically
active substance into aplastic resin before casting or the
like.
[0156] In addition, a DispersinB.TM.-based antimicrobial
composition can further comprise binders, wetting agents, odour
absorbing agents, levelling agents, adherents, thickeners, and the
like. Other additives may also be present on and/or within a fabric
of bandage including antistatic agents, optical brightening
compounds, opacifiers (such as titanium dioxide), nucleating
agents, antioxidants, UV stabilizers, fillers, permanent press
finishes, softeners, lubricants, curing accelerators, adhesives,
and the like.
[0157] In another embodiment, a DispersinB.TM.-based antimicrobial
composition can include a detergent. A detergent may be anionic,
cationic, or non-ionic. Detergents can include: sodium dodecyl
sulfate (SDS) (also known as lauryl sulfate, sodium salt (other
salts are also useful including lithium and potassium salts);
sodium cocomonoglyceride sulfonate; sodium lauryl sarcosinate;
sodium cholate; sodium deoxycholate; octylglucoside; dodecyldi in
ethylamine oxide;
3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS);
dodecyltriethylammonium bromide (DTAB); cetyltrimethylammonium
bromide (CTAB); polyoxyethylene-p-isooctylphenyl ether (e.g.,
Triton.RTM. X-20, Triton.RTM. X-100, Triton.RTM.X-114); alkyl
sulfate; alkyl sulfonate; quaternary amines;
octyldecyldimethylammonium chloride; dioctyldimethylammonium
chloride; didecyldimethylammonium chloride; cetylpyridinium
chloride; benzalkonium chloride; benzyldodecyldimethylammonium
bromide; thonzonium bromide; cholic acid; chenodeoxycholic acid;
glycodeoxycholic acid sodium salt; cremophor EL;
N-Nonanoyl-N-methylglucamine; saponin; surfactin; protamine, and
colistin.
Therapeutic Use for Treating Oral Infections
[0158] In an embodiment, a DispersinB.TM.-based antimicrobial
composition can treat an oral infection. Oral infections include
microorganisms in the subgingival and supragingival plaque.
Subgingival plaque comprises microorganisms can cause periodontal
disease. Periodontal disease includes gingivitis, periodontitis,
acute necrotizing ulcerative gingivitis (ANUG), and localized
juvenile periodontitis (LJP). Symptoms of periodontal disease
include inflammation of the gingiva, deepening periodontal pockets,
and alveolar bone loss.
[0159] A. actinomycetemcomitans is the principal etiologic agent of
LJP and is considered a putative etiologic agent for generalized
periodontitis, also referred to as adult periodontitis. Prevotella
intermedia is considered the chief etiologic agent for ANUG and is
also considered a putative etiologic agent of adult periodontitis.
Porphyromonas gingivalis is considered the main etiologic agent of
chronic and severe adult periodontitis, but other microorganisms
are thought to contribute to adult periodontitis as well. Other
etiologic agents of periodontal diseases include Fusobacterium
nucleatum, Treponema denticola, Eikenella corrodens, P. nigrescens,
Campylobacter rectus, Prevotella nigrescens, and Bacteroides
forsythus.
[0160] In an embodiment, a DispersinB.TM.-based composition can be
used to treat oral infections. Preferably, an oral infection would
include dental plaque that causes periodontal disease. In another
embodiment, an oral infection includes Streptococcus mutans, the
etiologic agent of caries.
[0161] In an embodiment, a method includes administering a
composition comprising (a) DispersinB.TM., an active fragment or
variant thereof that disperses a biofilm; and (b) an antimicrobial
agent. The antimicrobial agent can be an amount to kill or inhibit
microorganisms that cause periodontal disease. In another
embodiment, the antimicrobial agent can be an amount to kill or
inhibit S. mutans.
[0162] A structural matrix established during biofilm formation can
make colonizing cells able to withstand normal treatment doses of
an antimicrobial. In a biofilm, a glycocalyx matrix serves as a
barrier that protects and isolates microorganisms from
antimicrobials and host defenses (e.g., antibodies, macrophages,
etc.) (Costerton et al., 1981, Ann. Rev. Microbiol. 35:299-324). In
one study, biofilm-associated bacteria were able to survive a
concentration of antibiotic 20 times the concentration effective to
eliminate the same species of bacteria grown in planktonic culture
(Nickel et al., 1985, Antimicrob. Agents Chemother. 27:619-624).
Higher doses of antimicrobials necessary to eliminate biofilm
growth may not be well tolerated in a mammal, particularly a human.
A DispersinB.TM.-based composition can overcome this structural
protection of biofilm-embedded microorganisms. DispersinB.TM. can
break up a biofilm matrix, whereby the antimicrobial then has
access to the microorganisms.
Gel Formulations
[0163] In another embodiment, the present invention provides
antibiofilm enzyme-based wound gel compositions comprising
DispersinB.TM., or an active fragment or variants thereof, and an
antimicrobial agent, can inhibit biofilm formation as well as
biofilm growth. In particular, a composition can include (a)
DispersinB.TM., an active fragment or a variant thereof, and (b)
triclosan or a broad-spectrum antimicrobial. Such compositions are
effective in inhibiting growth and proliferation of
biofilm-embedded microorganisms, including both bacterial and
fungal species. A composition can further comprise a viscosity
improving agent.
[0164] Accordingly, an embodiment of the present invention provides
wound gel compositions for: (a) DispersinB.TM. antimicrobial wound
gel with a viscosity improving agent (gelling agent); and (b)
Triclosan-DispersinB.TM. antimicrobial wound gel with a viscosity
improving agent. In both the wound gels DispersinB.TM. or an active
fragment or variants thereof could be used.
[0165] Also, other antimicrobials including, but not limited to,
triclosan, antibiotics (such as rifampicin, cefamandole nafate and
ciprofloxacin) nitrofurazone, bismuth-thiols [such as bismuth
ethanedithiol (BisEDT)], chitosan, epigallocatechin gallate (EGCG),
sodium usnate, antineoplastic agents (such as 5-fluorouracil),
detergents (such as SDS, benzalkonium chloride), chlorhexidine,
chelating agents (such as EDTA), silver compounds, bacteriophage,
antimicrobial enzymes (such as glucose oxidase and
lactoperoxidase), sugar alcohols (such as xylitol), maleimides
[such as N,N-(1,2 phenylene) dimaleimide (oPDM) and N-(1-pyrenyl)
maleimide (PyrM)], cadexomer iodine, methylene blue, gentian
violet, medium chain dextrans (such as honey), and mixtures thereof
can be used in combination with DispersinB.TM..
[0166] According to another embodiment, a Triclosan-DispersinB.TM.
wound gel comprises about 1% triclosan. In a further embodiment, a
DispersinB.TM. wound gel and a Triclosan-DispersinB.TM. wound gel
can optionally further comprises a gelling agent and/or a viscosity
improving agent.
[0167] Triclosan-DispersinB.TM. wound gel can be prepared in
polyethylene glycol (PEG)/ethanol. PEG of molecular weights ranging
between 200 and 511000 can be used in the gel formulation.
According to another embodiment, a Triclosan-DispersinB.TM. wound
gel is prepared in 10% polyethylene glycol (PEG) 400 plus 10%
ethanol.
[0168] According to another embodiment, a viscosity increasing
agent is an alginate based material. There are a number of suitable
viscosity increasing agents available and, as previously indicated,
preferred embodiments of the present invention will rely on gelling
agents. A number of gelling agents are available including various
gums and polysaccharides, alginates, and both synthetic and natural
polymeric compounds. Such gelling agents are well known in the art,
in particular in the food and medical arenas and will not be
discussed in any specific detail herein apart from some
representative examples given later herein. Some useful prior art
referencing the use of gelling agents in medical type applications
include U.S. Pat. No. 4,948,575, U.S. Pat. No. 5,674,524, U.S. Pat.
No. 5,197,954, U.S. Pat. No. 5,735,812, U.S. Pat. No. 5,238,685,
U.S. Pat. No. 5,470,576, U.S. Pat. No. 5,738,860, U.S. Pat. No.
5,336,501, U.S. Pat. No. 5,482,932. Reference is made to these
documents as a background to various viscosity increasing agents,
which may find with the present invention.
[0169] A DispersinB.TM. based antimicrobial wound gel can be used
to inhibit the proliferation of biofilm-embedded gram-negative and
gram-positive bacteria, which include, but are limited to:
Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae,
Pseudomonas aeruginosa, Klebsiella oxytoca, Providentia sturtii,
Serratia marcescens, Enterobacter cloacae, Enterococcus faecalis,
Vancomycin Resistant Enterococci (VRE), Peptostreptococcus spp.,
Corynebacterium spp., Clostridium spp., Bacteriodes spp.,
Prevotella spp., Streptococcus pyogenes, Streptococcus viridans,
Micrococcus spp., Beta-hemolytic streptococcus (groupC),
Beta-hemolytic streptococcus (groupB), Bacillus spp., Porphyromonas
spp., Staphylococcus epidermidis, S. aureus. S. agalactiae and S.
saprophyticus.
[0170] Additionally, a DispersinB.TM. based antimicrobial
composition can also be used to inhibit the proliferation of
biofilm-embedded fungi, such as Candida albicans, Candida
parapsilosis, and Candida utilis.
Use of Gel Formulations
[0171] DispersinB.TM. based antibiofilm gel formulations can be
administered to subjects to inhibit biofilms. Such biofilms can
include bacteria, fungi, or a mixture of bacteria and fungi.
Biofilms can be associated with wounds. Administration of a
DispersinB.TM. based antibiofilm wound gel can also be achieved
wherein a wound dressing or device comprises said DispersinB.TM.
based antibiofilm gel formulations.
[0172] A DispersinB.TM. based antibiofilm gel formulation that is
administered to treat a biofilm can also include an antimicrobial,
such as triclosan. As further described in the examples, a
triclosan-DispersinB.TM. antibiofilm formulation significantly, if
not totally, ablates biofilm growth and/or survival.
[0173] In one aspect, a DispersinB.TM. based antibiofilm wound gel
can be used for treating a wounds that includes but is not limited
to, a cutaneous abscess, surgical wound, sutured laceration,
contaminated laceration, blister wound, soft tissue wound, partial
thickness burn, full thickness burn, decubitus ulcer, stasis ulcer,
foot ulcer, venous ulcer, diabetic ulcer, ischemic ulcer, pressure
ulcer, or combinations thereof.
[0174] A wound gel is preferably applied following wound
debridement. Although biofilm bacteria cannot be completely
eradicated from a wound area by debridement, decreasing bio film
mass and providing increased exposure of the debrided tissue and
remaining biofilm bacteria to a wound gel increases wound healing.
The slough that fills a chronic wound, previously thought to be
comprised of dead cells, cellular debris, bacteria, and tissue
fluid, has recently been demonstrated to be comprised primarily of
a mixed-species bacterial biofilm. It is therefore of benefit to
debride the slough from the wound as completely as possible.
Debridement can be performed by surgical, mechanical, autolytic,
enzymatic, or a combination of means known to those of skill in the
art of wound care.
[0175] A wound gel could be applied on chronic wounds along with
systemic administration of antibiotics. At present antibiotics are
not effective against some chronic wounds as biofilm embedded cells
are more resistant to antibiotics. Application of a wound gel with
antibiofilm activity will disrupt biofilm embedded cells and
systemically administered antibiotics will kill dispersed cells.
Therefore, a wound gel of present invention will improve the
activity of antibiotics.
[0176] A DispersinB.TM. wound gel could be used sequentially along
with antimicrobial agents, which are not compatible with enzymes
such as detergents. A DispersinB.TM. wound gel can be applied on
wounds first to disperse biofilm embedded cells and then
antimicrobial agents.
[0177] A wound gel of the present invention utilizes alginate salts
to form a product of the desired viscosity (e.g. gel, putty or
pliable sheet, etc.). Alginates appear to be especially suitable
for use with a wound gel since physical properties of a gel product
appear to be relatively easily controlled. Introduction of
polyvalent cations helps to form a gel product of desired
consistency. Any moulding, extruding, or forming processes should
also be performed at this time so that a final product could be
formed into desired configuration. Machining (e.g. slicing) into a
final form, such as sheets cut from a block, can also be
incorporated into any manufacturing process.
[0178] Alginates can also have other potentially realisable
advantages by introducing cations or cations that are already a
part of the selected alginate. For instance, calcium containing
alginates may be selected where there is bleeding, as calcium can
promote blood clotting. Another example of advantageous cation
exchange by an alginate includes alginate fibre dressings that are
high in mannuronic acid, wherein the fibre dressings can readily
exchange calcium ions for sodium ions. This increases fluid uptake
by the dressing, which consequently forms a soft gel that can be
easily flushed away with saline. Fibre dressings high in guluronic
acid form stronger gels that keep their shape, making removal in
one piece possible.
[0179] Alginates can exhibit gelling and cross linking properties
promoted by the presence of polyvalent cations. These often tend to
form tougher and less soluble alginate materials and thus may find
use in a number of products for altering physical characteristics.
Such a modification can be used for a sheet-like embodiment,
particularly as a way of increasing the strength or solubility
properties of a resulting sheet.
[0180] Polyvalent cations may be introduced in a number of ways,
including introduction of a soluble solution of polyvalent cations
during the blending procedure. Preferably, this should be after
gelling of a blend has been initiated to avoid thickening
reactions, which interfere with the dispersion and hydrating of all
of the sodium (or other) alginate being blended with DispersinB.TM.
and triclosan. However, adding polyvalent cations at different
points can theoretically substantially alter the characteristics of
the resulting product and thus a number of options open to the user
to allow them to tailor the physical characteristics of products
according to the intended end use and user requirements. It is
anticipated that soluble calcium salts, such as calcium chloride,
may be introduced at relatively low concentrations to promote the
various gelling and cross reactions.
[0181] Sheets from wound gels can be formed by placing wound gel in
between sheets of a non-wettable material and rolling it to uniform
thickness. As a variation, a gauze fabric or other suitable
material may be placed on top of a lower non-wettable sheet prior
to pouring a wound gel. The rolling procedure is completed with a
sheet-like gel bonded to gauze. Various materials could be used to
apply DispersinB.TM. based wound gel including, without
limitations, fibres, and fabrics. A fabric may be formed from
fibres such as synthetic fibres, natural fibres, or combinations
thereof. Synthetic fibres include, for example, polyester, acrylic,
polyamide, polyolefin, polyaramid, polyurethane, regenerated
cellulose (i.e. rayon), and blends thereof. Suitable polymeric
materials include but are not limited to silastic or other
silicone-based material, polyethylenetecephtalate (PET),
Dacron.RTM., kilted Dacron.RTM., velour Dacron.RTM., polyglacin,
chromic gut, nylon, silk, bovine arterial graft, polyethylene (PE),
polyurethane, polyvinyl chlorides silastic elastomer, silicone
rubber, PMMA[poly-(methylmethacrylate), latex, polypropylene (PP),
polyolefin, cellulose, poly vinyl] alcohol (PVA),
poly(hydroxymethyl)methacrylate (PHEMA), Poly(glycolic acid), poly
(acrylonitrate) (PAN), fluoroethylene-cohexa-fluoropropylene (FEP),
Teflon.RTM. (PTFE), Cobalt-Cromium alloys, copolymers thereof and
mixtures thereof.
[0182] Other potentially useful gelling agents include
hydrocolloids and hydrogels. These components tend to absorb
moisture to form a moist healing environment and tend to absorb
less fluid than the alginates. Consequently it is envisaged that
they would not be used for embodiments for heavily exuding wounds
in which alginates would tend to offer better performance. However,
it is envisaged that combinations of various viscosity increasing
agents may be used in particular embodiments, particularly each
imparts a slightly difference property which helps fulfil a
particular specification required by the user. For instance the
hydrocolloids or hydrogels may be incorporated into gelling blends
to vary properties such as the amount of fluid absorbed from a
wound, etc.
[0183] In addition, DispersinB.TM. based wound gels can further
comprise binders, wetting agents, odour absorbing agents, levelling
agents, adherents, thickeners, coupling agents, pH adjusters, and
the like.
[0184] A formulation of the present invention may be used for human
wound therapy or for veterinary use. A formulation may be applied
topically to one or more wounds of, for example, a dog, cat, or
other mammal. A formulation may be applied to a bite wound to
protect a human from developing an ulcerated wound as the result of
infection (often with biofilm fragments from the mouth of the
animal).
[0185] Compositions of the invention can also include quorum
sensing inhibitors (QSIs). Quorum sensing is a means of
communication between bacteria, most notably in a biofilm. Quorom
sensing is mediated by N-acyl-homoserine lactones (AHLs) in
gram-negative bacteria and mostly through small peptides in gram
positive bacteria (March & Bentley, Curr. Opin. Biotechnol. 15:
495-502 (2004)). Quorom sensing inhibitors can inhibit AHL
expression, dissemination, and signal reception. For instance, the
Bacillus enzyme AiiA hydrolyzes AHLs (Dong et al., Proc. Natl.
Acad. Sci. USA 97: 3526-3531 (2000)). Other QSIs can include AIIL
analogs that compete and/or interfere with AHL binding to a
receptor (e.g., LuxR). These antagonist AHLs can include AHLs with
a longer acyl side chains (e.g., extended with at least one
methylene), AHLs with decreased acyl side chain rotation (e.g.,
introduction of an unsaturated bond close to the amide linkage), or
a substitution to the phenyl ring (e.g., para-bromo). Other QSIs
include furanone compounds (Wu et al., J. Antimicrob. Chemother.
53; 1054-1061 (2004)) such as
(5Z)-4-bromo-5-(bromomethylene)-3-butyl-2(5H)-furanone (Jones et
al., J. Infect. Dis. 191: 1881-1888 (2005)),
4-nitro-pyridine-N-oxide, garlic extract, p-benzoquinone,
2,4,5-tri-bromo-imidazole, 3-amino-benzen-sulfonamide, and
3-nitro-benzen-sulfonamide (Rasmussen et al., J. Bacteriol. 187:
1799-1814 (2005)).
[0186] Compositions of the invention can also include RNAIII
inhibitory peptide (RIP) (U.S. Pat. No. 6,291,431). RIP is a
heptapeptide (YSPWTNF-NH.sub.2; SEQ TD NO: 5) that inhibits S.
aureus and S. epidermidis adhesion to surfaces (e.g., epithelial
cells, polymers). Compositions can also include bacterial
transcription inhibitors which are known to be active against
biofilms (Guillot et al., 2007, Antimicrob. Agents Chemother.
51:3117-3121).
[0187] Methods to modulate biofilm detachment can include
DispersinB.TM. and other molecules mentioned above. DispersinB.TM.
can be administered to a biofilm concurrently or prior to
administering QSIs and/or an antimicrobial. Further, a combination
of DispersinB.TM. and QSIs can be administered concurrently or
prior to administering an antimicrobial.
Therapeutic Delivery of Bacteriophages
[0188] "Bacteriophage" or "phage" are viruses that infect bacteria.
Many phage have the ability to lyse bacteria, usually occurring
after viral assembly is completely so fully assembled virus can
exit the host cell.
[0189] Phage display is a system in which a protein and small
peptides are displayed on the surface of a phage as a fusion with
one of the coal proteins of the virus. Phage display is a powerful
tool that allows the discovery and characterization of proteins
that interact with a desired target. Phage display peptide
libraries are produced with billions of unique displayed proteins
(see, e.g., U.S. Pat. No. 5,702,892). Phage display libraries are
well known and extensively used to investigate ligand-receptor
binding.
[0190] Due to accessibility to solvents, displayed proteins and
peptides frequently adopt their native conformation, and behave
essentially as it is not attached to the surface of a phage.
Therefore, most proteins and peptides attached to phage surfaces
are biologically active, and can be used directly without time
consuming purification and refolding steps that is otherwise needed
for proteins expressed using bacterial and eukaryotic expression
systems.
[0191] Using phages as antimicrobial agents for infection control
has been demonstrated in animal models for Escherichia coli
(Merrill et al., Proc. Natl. Acad. Sci. USA (1996) 93: 3188-3192;
Smith & Huggins, J. Gen. Microbiol. (1982) 128: 307-318; Smith
& Huggins, Gen. Microbiol. (1983) 129: 2659-2675; Smith et al.,
J. Gen. Microbiol. (1987) 133: 1111-1126; Smith et al., J. Gen.
Microbiol. (1987) 133: 1127-1135)); Pseudomonas aeruginosa
(Soothill, J. Med. Microbiol. (1992) 37: 258-261; Soothill, Burns
(1994) 20: 209-211); Salmonella enterica serovar typhimurium
(Berchieri et al., Res. Microbiol. (1991) 142: 541-549);
Staphylococcus aureus (Matsuzaki et al., J. Infect. Dis. (2003)
187: 613-624); and Vibrio vulnificus (Cerveny et al., Infect.
Immun. (2002) 70: 6251-6262). Using bacteriophage to treat
biofilm-associated infection, however, is problematic because a
biofilm acts as a diffusion barrier to the phage (Doolittle et al.,
Can. J. Microbiol. (1995) 41: 12-18; Doolittle et al, Ind. J.
Microbiol. (1996) 16: 331-341).
[0192] Routes of administration of phage therapy include but are
not limited to: oral, aerosol or other device for delivery to the
lungs, nasal spray, intravenous, intramuscular, intraperitoneal,
intrathecal, vaginal, rectal, topical, lumbar puncture,
intrathecal, and direct application to the brain and/or meninges.
Excipients which can be used as a vehicle for the delivery of phage
are well known. For example, free phage could be in lyophilized
form and be dissolved just prior to administration by IV injection.
Dosage of administration is contemplated to be about 10.sup.6
pfu/kg/day, about 10.sup.7 pfu/kg/day, about 10.sup.8 pfu/kg/day,
about 10.sup.9 pfu/kg/day, about 10.sup.10 pfu/kg/day, about
10.sup.11 pfu/kg/day, about 10.sup.12 pfu/kg/day, or about
10.sup.13 pfu/kg/day. Phage can be administered until successful
elimination of pathogenic bacteria is achieved.
[0193] With respect to aerosol administration, antimicrobial phage
can be incorporated into an aerosol formulation specifically
designed for administration to the lungs by inhalation. Many such
aerosols are well known, and the present invention is not limited
to any particular formulation. An example of such an aerosol is the
Proventil.TM. inhaler manufactured by Schering-Plough, the
propellant of which contains trichloromonofluoromethane,
dichlorodifluoromethane, and oleic acid. Concentrations of
propellant ingredients and emulsifiers are adjusted if necessary
based on the phage being used in the treatment. The number of phage
to be administered per aerosol treatment can be about 10.sup.6 pfu,
about 10.sup.7 pfu, about 10.sup.8 pfu, about 10.sup.9 pfu, about
10.sup.10 pfu, about 10.sup.11 pfu, about 10.sup.12 pfu, or about
10.sup.13 pfu.
Treatment of Devices
[0194] In a further embodiment, a composition(s) of the present
invention can be used to inhibit the growth and proliferation of
biofilm embedded microorganisms on devices, and in particular,
medical devices. The compositions of the present invention can be
used in the preparation of medical devices for implantation in a
mammal. A medical device to be implanted can be coated,
incorporated or treated with a composition(s) of the present
invention. A composition(s) of the present invention can also be
used to prevent infections caused by an implanted medical device,
including but not limited to urinary tract infections and vascular
infections.
[0195] In one embodiment, a composition comprises DispersinB.TM. or
an active fragment thereof in combination with triclosan. An amount
of DispersinB.TM. included in a composition is preferably between
about 0.1 and 500 .mu.g/ml and more preferably about 40 .mu.g/ml.
The higher end of this range can be used to prepare a concentrated
product which may be diluted prior to use. The amount of triclosan
included in a composition is preferably between about 0.1 and 100
mg/ml and more preferably about 10 mg/ml. The higher end of this
range can be used to prepare a concentrated product which may be
diluted prior to use.
[0196] In another embodiment of the present invention, the
composition comprises effective amounts of DispersinB.TM. and
rifampicin. In yet another embodiment of the present invention, the
composition comprises effective amounts of DispersinB.TM. and
cefamandole nafate. In yet another embodiment of the present
invention, the composition comprises effective amounts of
DispersinB.TM. and nitrofurazone.
[0197] Higher concentrations of a compound can be used for certain
applications depending on targeted bacteria and a device to be
treated. Suitable working concentrations can easily be determined
using known methods.
[0198] In an embodiment of the present invention, wound dressings
including but not limited to sponges or gauzes can be impregnated
with the isolated DispersinB.TM. protein or active fragment or
variant thereof to prevent or inhibit bacterial or fungal
attachment and reduce the risk of wound infections, Similarly,
catheter shields as well as other materials used to cover a
catheter insertion sites can be coated or impregnated with a
DispersinB.TM. protein or active fragment or variant thereof to
inhibit bacterial or fungal biofilm attachment thereto. Adhesive
drapes used to prevent wound infection during high risk surgeries
can be impregnated with the isolated protein or active fragment or
variant thereof as well. Additional medical devices which can be
coated with a DispersinB.TM. protein or active fragment or variant
thereof include, but are not limited, central venous catheters,
intravascular catheters, urinary catheters, Hickman catheters,
peritoneal dialysis catheters, endotracheal catheters, mechanical
heart valves, cardiac pacemakers, arteriovenous shunts, schleral
buckles, prosthetic joints, tympanostomy tubes, tracheostomy tubes,
voice prosthetics penile prosthetics, artificial urinary
sphincters, synthetic pubovaginal slings, surgical sutures, hone
anchors, bone screws, intraocular lenses, contact lenses,
intrauterine devices, aortofemoral grafts and vascular grafts.
Exemplary solutions for impregnating gauzes or sponges, catheter
shields and adhesive drapes or coating catheter shields and other
medical devices include, but are not limited to, phosphate buttered
saline (pH approximately 7.5) and bicarbonate butter (pH
approximately 9.0). In yet another embodiment, an isolated
DispersinB.TM. protein or active fragment or variant thereof can be
incorporated in a liquid disinfecting solution. Such solutions may
further comprise antimicrobials or antifungals such as alcohol,
providone-iodine solution and antibiotics as well as preservatives.
These solutions can be used, for example, as disinfectants of the
skin or surrounding area prior to insertion or implantation of a
device such as a catheter, as catheter lock and/or flush solutions,
and as antiseptic rinses for any medical device including, but not
limited to catheter components such as needles, Leur-Lok.RTM.
connectors, needleless connectors and hubs as well as other
implantable devices. These solutions can also be used to coat or
disinfect surgical instruments including, but not limited to,
clamps, forceps, scissors, skin hooks, tubing, needles, retractors,
scalers, drills, chisels, rasps and saws. In a preferably
embodiment, the composition comprising DispersinB.TM., an active
fragment, or a variant thereof, and triclosan, is used to coat a
medical device, such as a catheter. Alternatively, the composition
comprising DispersinB.TM., an active fragment or a variant thereof,
and triclosan, can be incorporated into the medical device as it is
being made, for example, through an extrusion process. Compositions
of the invention can be prepared using known methods. Generally,
components are dissolved in a suitable solvent, such as water,
glycerol, organic acids, and other suitable solvents
[0199] Compositions of the invention useful for the treatment of
devices may include any number of well known active components and
base materials. Such compositions may further comprise ingredients
such as, but not limited to: suitable solvents such as water;
antibiotics such antibacterials and antifungals; binding, bonding,
or coupling agent, cross-linking agent; or a pH adjuster.
[0200] Compositions of the invention useful for the treatment of
devices may further comprise additional antimicrobial ingredients
such as bis phenols, biguanides, anilides, diamidines,
halogen-releasing agents, metallic ions, chelating agents, cationic
peptides/polypeptides, N-substituted maleimides, and quaternary
ammonium compounds. Examples of bis-phenols useful for preparing
compositions of the present invention include, but are not limited
to, triclosan and hexachlorophene. Examples of biguanides useful
for preparing compositions of the present invention include, but
are not limited to, chlorhexidine, chlorhexidine salts, alexidine
and polymeric biguanides. Examples of anilides useful for preparing
compositions of the present invention include, but are not limited
to, triclocarban. Examples of diamidines useful for preparing
compositions of the present invention include, but are not limited
to, propamidine and dibromopropamidine. Examples of
halogen-releasing agents useful for preparing compositions of the
present invention include, but are not limited, to, iodine
compounds, silver compounds, silver nanoparticles and halophenols.
Examples of metallic ions useful for preparing compositions of the
present invention include, but are not limited to, gallium and
other related metal derivatives. Examples of chelating agents
useful for preparing compositions of the present invention include,
but are not limited to, lactoferrin, ovotransferrin,
serotransferrin, EDTA and EGTA. Examples of cationic
peptides/polypeptides useful for preparing compositions of the
present invention include, but are not limited to, protamine
sulfate, lysozyme and polylysine. Examples of N-maleimides useful
for preparing compositions of the present invention include, but
are not limited: to N-ethylmaleimide (NEM),
5,5-dithiobis-(2-nitrobenzoic acid) (DTNB), N-phenylmaleimide
(PheM), N-(1-pyrenyl) maleimide (PyrM), naphthalene-1,5-dimaleimide
(NDM), N,N'-(1,2-phenylene) dimaleimide (oPDM), N,N'-1,4-phenylene
dimaleimide (pPDM), N,N'-1,3-phenylene dimaleimide (mPDM), and
1,1-(methylenedi-4,1-phenylene)bismaleimide (BM). Examples of
quaternary ammonium compounds useful for preparing compositions of
the present invention include, but are not limited to benzalkonium
chloride, tridodecyl methyl ammonium chloride, cetrimide and
didecyl dimethyl ammonium chloride.
[0201] Other possible components of the composition include, but
are not limited to, buffer solutions, phosphate buffered saline,
saline, polyvinyl, polyethylene, polyurethane, polypropylene,
silicone (e.g., silicone lassoers and silicone adhesives),
polycarboxylic acids, (e.g., polyacrylic acid, polymethacrylic
acid, polymaleic acid, poly-(maleic acid monoester), polyaspartic
acid, polyglutamic acid, aginic acid or pectimic acid),
polycarboxylic acid anhydrides (e.g., polymaleic anhydride,
polymethacrylic anhydride or polyacrylic acid anhydride),
polyamines, polyamine ions (e.g., polyethylene imine,
polyvinylamine, polylysine, poly-(dialkylaminoethyl methacrylate),
poly-(dialkylaminomethyl styrene) or poly-(vinylpyridine),
polyammonium ions (e.g., poly-(2-methacryloxyethyl trialkyl
ammonium ion), poly-(vinylbenzyl trialkyl ammonium ions),
poly-(N,N-alkylpyridinium ion) or poly-(dialkyloctamethylene
ammonium ion) and polysulfonates (e.g. poly-(vinyl sulfonate) or
poly-(styrene sulfonate), collodion, nylon, rubber, plastic,
polyesters, Dacron.TM. (polyethylene tetraphthalate), Teflon.TM.
(polytetrafluoroethylene), latex, and derivatives thereof,
elastomers and Dacron (sealed with gelatin, collagen or albumin,
cyanoacrylates, methacrylates, papers with porous barrier films,
adhesives, e.g., hot melt adhesives, solvent based adhesives, and
adhesive hydrogels, fabrics, and crosslinked and non-crosslinked
hydrogels, and any other polymeric materials which facilitate
dispersion of the active components and adhesion of the biofilm
penetrating coating to at least one surface of the medical device.
Linear copolymers, cross-linked copolymers, graft polymers, and
block polymers, containing monomers as constituents of the
above-exemplified polymers may also be used.
[0202] Examples of biofilm embedded bacteria that may be inhibited
using compositions according to the invention include gram-negative
bacteria such as, but not limited to: Escherichia coli, Proteus
mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa,
Klebsiella oxytoca, Providentia stuartii, or Serratia marcescens
and gram-positive bacteria such as, but not limited to:
Enterococcus faecalis, Vancoinycin Resistant Enterococci (VRE),
Streptococcus viridans, Staphylococcus epidermidis, and
Staphylococcus aureus or Staphylococcus saprophyticus. These
bacteria are commonly found associated with medical devices
including catheters.
[0203] Compositions according to the invention can also be used to
inhibit the growth and proliferation of bio film embedded fungus
such as Candida albicans, Candida parapsilosis, and Candida utilis.
In another aspect, the present invention provides a method of
preparing a device comprising treating at least one surface of the
device with an effective amount of DispersinB.TM., an active
fragment or variant thereof, and an effective amount of triclosan,
according to the invention.
[0204] The term "effective" refers to a sufficient amount of active
components to substantially prevent growth or proliferation of
biofilm embedded microorganisms on at least one surface of a
medical device coated with an embodied composition; and as a
sufficient amount of the active components to substantially
penetrate, or break-up, a biofilm on at least one surface of a
medical device, thereby facilitating access of active components,
antimicrobial agents, and/or antifungal agents to microorganisms
embedded in a biofilm, and thus, removal of substantially all
microorganisms from at least one surface of a medical device
treated with a solution of an embodied composition. An amount will
vary for each active component and upon known factors such as
pharmaceutical characteristics; type of medical device; degree of
biofilm embedded microorganism contamination; and use and length of
use.
[0205] Examples of devices that can be treated using the
compositions of the invention include medical devices such as
tubing and other medical devices, such as catheters, pacemakers,
prosthetic heart valves, prosthetic joints, voice prostheses,
contact lenses, and intrauterine devices.
[0206] Medical devices include disposable or permanent or
indwelling catheters, (e.g., central venous catheters, dialysis
catheters, long-term tunneled central venous catheters, short-term
central venous catheters, peripherally inserted central catheters,
peripheral venous catheters, pulmonary artery Swan-Ganz catheters,
urinary catheters, and peritoneal catheters), long-term urinary
devices, tissue bonding urinary devices, vascular grafts, vascular
catheter ports, wound drain tubes, ventricular catheters,
hydrocephalus shunts heart valves, heart assist devices (e.g., left
ventricular assist devices), pacemaker capsules, incontinence
devices, penile implants, endotracheal tubes, small or temporary
joint replacements, urinary dilator, cannulas, elastomers,
hydrogels, surgical instruments, dental instruments, tubings, such
as intravenous tubes, breathing tubes, dental water lines, dental
drain tubes, and feeding tubes, fabrics, paper, indicator strips
(e.g., paper indicator strips or plastic indicator strips),
adhesives (e.g., hydrogel adhesives, hot-melt adhesives, or
solvent-based adhesives), bandages, wound dressings, orthopedic
implants, and any other device used in the medical field.
[0207] Medical devices also include any device which may be
inserted or implanted into a human being or other animal, or placed
at the insertion or implantation site such as the skin near the
insertion or implantation site, and which include at least one
surface which is susceptible to colonization by biofilm embedded
microorganisms.
[0208] Medical devices for the present invention include surfaces
of equipment in operating rooms, emergency rooms, hospital rooms,
clinics, and bathrooms.
[0209] Implantable medical devices include orthopedic implants,
which may be inspected for contamination or infection by biofilm
embedded microorganisms using endoscopy. Insertable medical devices
include catheters and shunts, which can be inspected without
invasive techniques such as endoscopy.
[0210] Medical devices may be formed of any suitable metallic
materials or non-metallic materials. Examples of metallic materials
include, but are not limited to, titanium, and stainless steel, and
derivatives or combinations thereof. Examples of non-metallic
materials include, but are not limited to, thermoplastic or
polymeric materials such as rubber, plastic, polyesters,
polyethylene, polyurethane, silicone, Gortex.TM.
(polytetrafluoroethylene), Dacron.TM. (polyethylene
tetraphthalate), Teflon.TM. (polytetrafluoroethylene), latex,
elastomers, and Dacron.TM. sealed with gelatin, collagen, or
albumin, and derivatives or combinations thereof.
[0211] In a preferred embodiment, the method of treating at least
one surface of a medical device comprises contacting a medical
device with a composition according to the invention. As used
herein, the term "contacting" includes, but is not limited to:
coating, spraying, soaking, rinsing, flushing, submerging, and
washing. A medical device is contacted with a composition for a
period of time sufficient to remove substantially all biofilm
embedded microorganisms from a treated surface of a medical
device.
[0212] In a more preferred embodiment, a medical device is
submerged in a composition for at least 5 minutes. Alternatively, a
medical device may be flushed with a composition. In the case of a
medical device being tubing, such as dental drain tubing, a
composition may be poured into a dental drain tubing and both ends
of the tubing clamped such that the composition is retained within
the lumen of the tubing. The tubing is that allowed to remain
filled with the composition for a period of time sufficient to
remove substantially all of the microorganisms from at least one
surface of the medical device, generally, for at least about 1
minute to about 48 hours. Alternatively, tubing may be flushed by
pouring a composition into the lumen of the tubing for an amount of
time sufficient to prevent substantial growth of all biofilm
embedded microorganisms. Concentrations of active components in a
composition may vary as desired or necessary to decrease the amount
of time the composition is in contact with a medical device.
[0213] In another embodiment of a method for treating a surface of
a device, a composition of the invention may also include an
organic solvent, a medical device material penetrating agent, or
adding an alkalinizing agent to the composition, to enhance
reactivity of a surface of the medical device with the composition.
An organic solvent, medical device material penetrating agent,
and/or alkalinizing agent are those which preferably facilitate
adhesion of a composition to at least one surface of a medical
device.
[0214] Another aspect provides a method of coating a composition of
the invention onto at least one surface of a device. Preferably,
the device is a medical device. Broadly, a method for coating a
medical device includes the steps of providing a medical device;
providing or forming a composition coating; and applying the
composition coating to at least one surface of the medical device
in an amount sufficient to substantially prevent growth or
proliferation of biofilm embedded microorganisms on at least one
surface of the medical device. In one specific embodiment, a method
for coating a medical device includes the steps of forming a
composition of the invention of an effective concentration for
activating an active component, thereby substantially preventing
growth or proliferation of microorganisms on at least one surface
of the medical device, wherein the composition of the invention is
formed by combining an active component and a base material. At
least one surface of a medical device is then contacted with a
composition of the invention under conditions wherein the
composition of the invention covers at least one surface of the
medical device. The term "contacting" further includes, but is not
limited to: impregnating, compounding, mixing, integrating,
coating, spraying and dipping.
[0215] In another embodiment of a method for coating a medical
device, a composition coating is preferably formed by combining an
active component and a base material at room temperature and mixing
the composition for a time sufficient to evenly disperse active
agents in the composition prior to applying the composition to a
surface of the device. A medical device may be contacted with a
composition for a period of time sufficient for a composition to
adhere to at least one surface of the device. After a composition
is applied to a surface of a device, it is allowed to dry.
[0216] A device is preferably placed in contact with a composition
by dipping the medical device in the composition for a period of
time ranging from about 30 seconds to about 180 minutes at a
temperature ranging from about 25.degree. C. to about 60.degree. C.
Preferably, a device is placed in contact with a composition by
dipping the medical device in the composition for about 60 minutes
at a temperature of about 37.degree. C. A device is removed from a
composition and then allowed to dry. A medical device may be placed
in an oven or other heated environment for a period of time
sufficient for a composition to dry.
[0217] Although one layer, or coating, of a composition is believed
to provide a desired composition coating, multiple layers are
preferred. Multiple layers of a composition are preferably applied
to at least one surface of a medical device by repeating steps
discussed above. Preferably, a medical device is contacted with a
composition three times, allowing the composition to dry on at
least one surface of the medical device prior to contacting the
medical device with the composition for each subsequent layer.
Thus, a medical device preferably includes three coats, or layers,
of a composition on at least one surface of the medical device.
[0218] In another embodiment, a method for coating medical devices
with a composition coating includes the steps of forming a
composition coating of an effective concentration to substantially
prevent the growth or proliferation of biofilm embedded
microorganisms on at least one surface of a medical device by
dissolving an active component in an organic solvent, combining a
medical device material penetrating agent to the active
component(s) and organic solvent, and combining an alkalinizing
agent to improve reactivity of the material of the medical device.
A composition is then heated to a temperature ranging from about
30.degree. C. to about 60.degree. C. to enhance adherence of a
composition coating to at least one surface of the device. A
composition coating is applied to at least one surface of a medical
device, preferably by contacting the composition coating to the at
least one surface of the medical device for a sufficient period of
time for the composition coating to adhere to at least one surface
of the medical device. A medical device is removed from a
composition coating and allowed to dry, preferably, for at least 18
hours at room temperature. A medical device may then be rinsed with
a liquid, such as water and allowed to dry for at least 2 hours,
and preferably 4 hours, before being sterilized. To facilitate
drying of a composition of the invention onto a surface of a
medical device, a medical device may be placed into a heated
environment such as an oven.
[0219] In another aspect, the invention provides a method of
incorporating a composition according to the invention into a
device. Preferably, a device is a medical device and a composition
is incorporated into a material forming the medical device during
formation of the medical device. For example, a composition may be
combined with a material forming the medical device, e.g.,
silicone, polyurethane, polyethylene, Gortex.TM.
(polytetrafluoroethylene), Dacron.TM. (polyethylene
tetraphthalate), and Teflon.TM. (polytetrafluoroethylene), and/or
polypropylene, and extruded with the material forming the medical
device, thereby incorporating the composition into material forming
the medical device. In this embodiment, the composition may be
incorporated in a septum or adhesive, which is placed at the
medical device insertion or implantation site. One example of a
medical device having a composition incorporated into the material
forming the medical device in accordance with this embodiment is a
catheter insertion seal having an adhesive layer described below in
greater detail. Another example of a medical device having a
composition incorporated into the material is an adhesive. A
composition of the invention can be integrated into an adhesive,
such as tape, thereby providing an adhesive, which may prevent
growth or proliferation of biofilm embedded microorganisms on at
least one surface of the adhesive.
EXAMPLES
Example 1
Effect of DispersinB.TM. on Biofilm Formation
[0220] An in vitro microplate assay was performed to determine the
effect of DispersinB.TM. on the growth and biofilm formation of E.
coli, S. epidermidis, and S. aureus. E. coli biofilm was grown in
colony forming antigen (CFA) medium. Purified DispersinB.TM. was
obtained from Jeffrey Kaplan (University of Medicine and Dentistry
of New Jersey) and was produced as described in Kaplan et al.,
2003, J. Bacteriol. 185: 4693-4698. S. epidermidis and S. aureus
biofilm was grown in tryptic soy broth (TSB). Bacteria were
separately grown in 96-well microliterplate in the absence and
presence of DispersinB.TM. at different concentrations. The E. coli
plate was incubated at 26.degree. C. for 24 hours. The S.
epidermidis and S. aureus biofilm plates were incubated at
37.degree. C. for 24 hours. Growth of planktonic cells based on the
absorbance at 600 nm was determined using Labsystems Multiskan
Ascent microplate reader. Biofilm was measured by discarding the
medium; rinsing the wells with water (three times), and staining
bound cells with crystal violet. The dye was solubilized with 33%
acetic acid, and absorbance at 630 nm was determined using a
microtiter plate reader. For each experiment, background staining
was corrected by subtracting the crystal violet bound to
uninoculated control (FIG. 1). The tests showed an appreciable
effect by DispersinB.TM. on biofilm formation among all the
cultures tested.
Example 2
Dispersal of S. epidermidis Biofilm by DispersinB.TM.
[0221] Dispersal of S. epidermidis biofilm by DispersinB.TM. was
demonstrated by growing S. epidermidis biofilm in a tube. The
biofilm growth from the surface was scraped from the bottom of the
tube and transferred to another tube (FIG. 2). Under these
condition cells formed a sticky aggregate that rapidly settle to
the bottom of the tube. Treatment of the cell aggregates with
DispersinB.TM. resulted in uniformly turbid cell suspensions
indicating that the treatment with DispersinB.TM. detaches the
biofilm.
Example 3
Enhanced Inhibitory Effect of DispersinB.TM. and Triclosan (TCSN)
Combination on Staphylococcus epidermidis Biofilm
[0222] An in vitro microplate assay was performed to determine the
effect of DispersinB.TM. and triclosan (an antimicrobial agent) on
the growth and biofilm formation of S. epidermidis. An overnight
culture of S. epidermidis in Tryptic Soy Broth (TSB) was used as
inoculum. Bacteria were grown in TSB on a 96-well microtiterplate
in the absence and presence of each compound (DispersinB.TM. or
TCSN) at different concentrations separately and together
(DispersinB.TM. TCSN). Concentrations of DispersinB.TM. included 25
ng/ml, 50 ng/ml, and 100 ng/ml. Concentrations of TCSN included 25
.mu.g/ml, 50 .mu.g/ml, and 100 .mu.g/ml. The plate was incubated at
37.degree. C. for 24 hours. The growth and biofilm was measured as
explained in Example 1. The combination of DispersinB.TM. and TCSN
(50 ng/ml+50 .mu.g/ml, respectively) showed enhanced inhibitory
effect on S. epidermidis biofilm formation (FIG. 3).
Example 4
Antimicrobial Activity of DispersinB.TM. and Triclosan (TCSN)
Combination Against Wound Infection-Associated Pathogens
[0223] The combined antimicrobial activity of DispersinB.TM. and
triclosan was studied by determining minimal inhibitory
concentrations (MIC) in a 96 well microtiter plate. Briefly, serial
two-fold dilutions of triclosan and in presence of DispersinB.TM.
(40 .mu.g/ml) were performed in TSB. A suspension or each
microorganism from Table 1 was added to wells at a concentration of
5.times.10.sup.5 CFU/mL, and the microtiter plates were incubated
at 37.degree. C. The MIC was defined, as the lowest concentration
of an antimicrobial required for total inhibition of a test
microorganism at 37.degree. C. Triclosan in combination with
DispersinB.TM. was active against all the pathogens tested.
TABLE-US-00003 TABLE 1 MIC of triclosan in the presence of
DispersinB .TM. (40 .mu.g/ml) enzyme against wound infection
associated pathogens Cultures MIC (.mu.g/ml) S. aureus <0.097 S.
epidermidis 3.125 E. faecalis 100 E. faecium Vancomycin resistant
25 E. faecium 12.5 E. coli 6.25 Enterobacter cloacae 25 P.
mirabilis 12.5 K. pneumoniae 25 C. albicans 100
Example 5
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Biofilm-Embedded Staphylococcus epidermidis to Antimicrobials
[0224] An in vitro biofilm-dispersal assay was performed to
determine whether DispersinB.TM. increased sensitivity of
biofilm-embedded S. epidermidis to rifampicin and/or cefamandole
nafate. S. epidermidis biofilm was grown in 1.5 ml polypropylene
microcentrifuge tubes (200 .mu.l culture volume), was rinsed with
200 .mu.l of fresh medium and then treated with 200 .mu.l medium
containing 100 .mu.g/ml of rifampicin or 0.1 .mu.g/till cefamandole
nafate, each alone or in combination with 20 .mu.g/ml of
DispersinB.TM.. After 3 hours at 37.degree. C., 10 .mu.l of 200
.mu.g/ml DispersinB.TM. was added to each tube, and tubes were
incubated for additional 5 min to detach biofilm. Serial dilutions
of cells were plated on TSA. DispersinB.TM. enhanced the inhibitory
effect of rifampicin and cefamandole nafate on biofilm-embedded S.
epidermidis (FIGS. 4 and 5). DispersinB.TM. dispersed S.
epidermidis biofilm and made it susceptible to rifampicin and
cefamandole nafate.
Example 6
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Staphylococcus epidermidis Biofilm to Nitrofurazone
[0225] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on enhancing the sensitivity
of S. epidermidis biofilm to nitrofurazone (NF). S. epidermidis
biofilm grown in 1.5 ml polypropylene microcentrifuge tubes was
rinsed with 200 .mu.l of fresh medium and then treated with 200
.mu.l medium containing 25 .mu.g/ml of NF and/or 20 .mu.g/ml of
DispersinB.TM.. Biofilm detachment and plating biofilm embedded
cells were performed as described in Example 5. When DispersinB.TM.
was used in combination with NF, there was increased sensitivity of
S. epidermidis biofilm to NF (FIG. 6). Thus, the DispersinB.TM. and
NF combination had an enhanced inhibitory effect on
biofilm-embedded S. epidermidis.
Example 7
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Staphylococcus epidermidis Biofilm to Bismuth ethanedithiol
(BisEDT)
[0226] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on enhancing the sensitivity
of S. epidermidis biofilm to bismuth ethanedithiol (BisEDT). S.
epidermidis biofilm grown in 1.5 ml polypropylene microcentrifuge
tubes was rinsed with 200 .mu.l of fresh medium and then treated
with 200 .mu.l medium containing 0.5 mM of BisEDT and/or 20
.mu.g/ml of DispersinB.TM.. Biofilm detachment and plating biofilm
embedded cells were performed as described in Example 5.
DispersinB.TM. in combination with BisEDT increased the sensitivity
of S. epidermidis biofilm to BisEDT (FIG. 7). Thus, the
DispersinB.TM. and BisEDT combination had an enhanced inhibitory
effect on biofilm-embedded S. epidermidis.
Example 8
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Staphylococcus epidermidis Biofilm to Ciprofloxacin (CF)
[0227] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on enhancing the sensitivity
of epidermidis biofilm to Ciprofloxacin (CF). S. epidermidis
biofilm grown in 1.5 ml polypropylene microcentrifuge tubes was
rinsed with 200 .mu.l of fresh medium and then treated with 200
.mu.l medium containing 200 .mu.g/ml of CF and/or 20 .mu.g/ml of
DispersinB.TM.. Biofilm detachment and plating biofilm embedded
cells were performed as described in Example 5. DispersinB.TM. in
combination with CF increased the sensitivity of S. epidermidis
biofilm to CF (FIG. 8). Thus, the DispersinB.TM. and CF combination
had an enhanced inhibitory effect on biofilm-embedded S.
epidermidis.
Example 9
Effect of DispersinB.TM. on the Sensitivity of Staphylococcus
epidermidis Biofilm to Lactoferrin (Lf)
[0228] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on the sensitivity of S.
epidermidis biofilm to lactoferrin (Lf). S. epidermidis biofilm
crown in 1.5 ml polypropylene microcentrifuge tubes was rinsed with
200 .mu.l of fresh medium and then treated with 200 .mu.l medium
containing 5 mg/ml of Lf and/or 20 .mu.g/ml of DispersinB.TM..
Biofilm detachment and plating biofilm embedded cells were
performed as described in Example 5. DispersinB.TM. in combination
with Lf, did not increase the sensitivity of S. epidermidis biofilm
to Lf (FIG. 9). Thus, the DispersinB.TM. and Lf combination did not
have an enhanced inhibitory effect on biofilm-embedded S.
epidermidis.
Example 10
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Staphylococcus epidermidis Biofilm to Conalbumin/Ovotransferrin
(OT)
[0229] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on enhancing the sensitivity
of S. epidermidis biofilm to ovotransferrin (OT). S. epidermidis
biofilm grown in 1.5 ml polypropylene microcentrifuge tubes was
rinsed with 200 .mu.l of fresh medium and then treated with 200
.mu.l medium containing 10 mg/ml of OT and/or 20 .mu.g/ml of
DispersinB.TM.. Biofilm detachment and plating biofilm embedded
cells were performed as described in Example 5. DispersinB.TM. in
combination with OT slightly increased the sensitivity of S.
epidermidis biofilm to OT (FIG. 10). Thus, the DispersinB.TM. and
OT combination had a slightly enhanced effect on biofilm-embedded
S. epidermidis.
Example 11
Effect of DispersinB.TM. on the Sensitivity of Staphylococcus
epidermidis Biofilm to Gallium (III) Nitrate
[0230] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on enhancing the sensitivity
of S. epidermidis biofilm to gallium (III) nitrate. S. epidermidis
biofilm grown in 1.5 ml polypropylene microcentrifuge tubes was
rinsed with 200 .mu.l of fresh medium and then treated with 200
.mu.l medium containing 5 mg/ml of gallium (III) nitrate and/or 50
.mu.g/ml of DispersinB.TM.. Biofilm detachment and plating biofilm
embedded cells were performed as described in Example 5.
DispersinB.TM. in combination with gallium (III) nitrate did not
increase the sensitivity of S. epidermidis biofilm to gallium (III)
nitrate (FIG. 11). Thus, DispersinB.TM. and gallium (III) nitrate
combination did not have an enhanced inhibitory effect on
biofilm-embedded S. epidermidis.
Example 12
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Staphylococcus epidermidis Biofilm to Chitosan
[0231] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on enhancing the sensitivity
of S. epidermidis biofilm to chitosan. S. epidermidis biofilm grown
in 1.5 ml polypropylene microcentrifuge tubes was rinsed with 200
.mu.l of fresh medium and then treated with 200 .mu.l medium
containing 2 mg/ml of chitosan and/or 20 .mu.g/ml of
DispersinB.TM.. Biofilm detachment and plating biofilm embedded
cells were performed as described in Example 5. DispersinB.TM. in
combination with chitosan slightly increased the sensitivity of S.
epidermidis biofilm to chitosan (FIG. 12). Thus, the DispersinB.TM.
and chitosan combination had a slightly enhanced inhibitory effect
on biofilm-embedded S. epidermidis.
Example 13
Effect of DispersinB.TM. and Epigallocatechin Gallate (EGCG) on
Biofilm Formation of Staphylococcus epidermidis and Staphylococcus
aureus
[0232] An in vitro microplate assays were performed to determine
the effects of a DispersinB.TM. and EGCG combination on the growth
of biofilm embedded S. epidermidis and S. aureus. Overnight
cultures of each bacterial strain grown in Tryptic Soy Broth (TSB)
were used as inoculum. Biofilm was developed in TSB on a 12-well
microplate in the absence and presence of each test compound (50 ng
DispersinB.TM. or 100 ng/ml ECCG) separately and together
(DispersinB.TM.+EGCG). The plates were incubated at 37.degree. C.
for 24 hours. Medium containing planktonic cells in each well was
removed gently and rinsed with sterile water. A known volume of
water was added to each well and sonicated for 30 seconds. The
contents of each well was transferred into a sterile tube, vortexed
for a minute, followed by 10-fold serial dilution, and plated on
agar plates using a spreader. Alter incubating the plates at
37.degree. C. for 24 hours, colony forming units (CPU) were
counted. Although EGCG was more effective than DispersinB.TM. in
inhibiting the growth of biofilm embedded test microorganisms,
together the combination of DispersinB.TM. and ECCG did not have an
enhanced inhibitory effect on biofilm-embedded S. epidermidis and
S. aureus (FIGS. 13 and 14).
Example 14
Dispersinb.TM. Increased the Sensitivity of Biofilm-Embedded
Staphylococcus epidermidis to Triclosan
[0233] An in vitro biofilm dispersal assay was performed to deter
mine the effect of DispersinB.TM. on the sensitivity of a S.
epidermidis biofilm to triclosan. A S. epidermidis biofilm grown in
1.5 ml polypropylene microcentrifuge tubes was rinsed with 200
.mu.l of fresh medium and then treated with 200 .mu.l medium
containing 1 mg/ml of triclosan and/or 20 .mu.g/ml of
DispersinB.TM.. A biofilm dispersal assay was performed as
described in the Example 5. When DispersinB.TM. was used in
combination with triclosan, sensitivity of biofilm-embedded S.
epidermidis to triclosan increased (FIG. 15). The DispersinB.TM.
and triclosan combination had an enhanced inhibitory effect on
biofilm-embedded S. epidermidis.
Example 15
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Biofilm-Embedded Staphylococcus epidermidis to Sodium Usnate
[0234] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on the sensitivity of S.
epidermidis biofilm to sodium usnate. A S. epidermidis biofilm
grown in 1.5 ml polypropylene microcentrifuge tubes was rinsed with
200 .mu.l of fresh medium and then treated with 200 .mu.l medium
containing 500 .mu.g/ml of sodium usnate and/or 50 .mu.g/ml of
DispersinB.TM.. A biofilm dispersal assay was performed as
described in Example 5. When DispersinB.TM. was used in combination
with sodium usnate, the sensitivity of biofilm-embedded S.
epidermidis to sodium: usnate increased (FIG. 16). The
DispersinB.TM. and sodium usnate combination had an enhanced effect
on biofilm-embedded S. epidermidis.
Example 16
Antimicrobial Activity of DispersinB.TM. and Triclosan (TCSN)
Combination Against Clinical Isolates of Wound-Associated
Pathogens
[0235] The antimicrobial activity of DispersinB.TM. and triclosan
combination was studied by determining the minimal inhibitory
concentrations (MIC) in 96 well microtiter plates as described in
Example 4. Triclosan in combination with DispersinB.TM. was active
against all the pathogens tested (Table 2).
TABLE-US-00004 TABLE 2 MIC of triclosan in the presence of
DispersinB .TM., 40 .mu.g/ml) enzyme for clinical isolates of
wound-associated pathogens Cultures MIC (.mu.g/ml) S. aureus Gav
16A <0.39 S. aureus 120 <0.39 S. aureus 68 <0.39
Coagulase-negative staphylococci (CNS 11) 25 CNS 82 <0.39 CNS 42
0.625
Example 17
Enhanced Inhibitory Effect of DispersinB.TM. and Triclosan (TCSN)
Combination on Coagulase-Negative Staphylococci (CNS) Biofilm
[0236] An in vitro microplate assay was performed to determine the
effect of DispersinB.TM. and triclosan combination on the growth
and biofilm formation of coagulase-negative Staphylococci-42
(CNS-42). The experiment was performed as explained in Example 1.
The combination of DispersinB.TM. and TCSN (100 ng/ml+1.25
.mu.g/ml, respectively) showed enhanced inhibitory effect on CNS-42
biofilm formation (FIG. 17).
Example 18
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Biofilm-Embedded Staphylococcus epidermidis to 5-fluorouracil
[0237] An in vitro biofilm dispersal assay was performed to
determine the effect of DispersinB.TM. on the sensitivity of
biofilm-embedded S. epidermidis to 5-fluorouracil (5-FU). S.
epidermidis biofilm grown in 1.5 ml polypropylene microcentrifuge
tubes was rinsed with 200 .mu.l of fresh medium and then treated
with 200 .mu.l medium containing 100 .mu.g/ml of 5-FU and/or 20
.mu.g/ml of DispersinB.TM.. Biofilm detachment and plating bio film
embedded cells were performed as described in Example 5. When
DispersinB.TM. was used in combination with 5-FU, there was
increased sensitivity of biofilm-embedded S. epidermidis to 5-FU
(FIG. 18). Thus, the DispersinB.TM. and 5-FU combination had an
enhanced inhibitory effect on biofilm-embedded S. epidermidis.
Example 19
Increase Susceptibility of Biofilm-Embedded Staphylococcus
epidermidis Pretreated with DispersinB.TM. to Killing by SDS
[0238] An in vitro biofilm assay was performed to determine the
effect of DispersinB.TM. pre-treatment on the susceptibility of S.
epidermidis to SDS. S. epidermidis biofilm grown in tubes were
pretreated with PBS or DispersinB.TM. (20 .mu.g/ml) for 30 min, and
then treated with SDS (0.2 mg/ml) for 5 min at 37.degree. C. The
untreated, DispersinB.TM. alone, or SDS alone did not significantly
kill biofilm-embedded epidermidis (FIG. 19). However, SDS caused a
1.5 log unit decrease in the number of CFUs in tubes pretreated
with DispersinB.TM. pre-treatment made biofilm embedded cells more
susceptible to SDS. This shows that sequential application of
DispersinB.TM. enzyme and an antimicrobial agent is possible, when
an antimicrobial agent is not compatible with the enzyme.
Example 20
Increased Susceptibility of Biofilm-Embedded Staphylococcus
epidermidis Pretreated with DispersinB.TM. to Killing by
Chlorhexidine (CHX)
[0239] An in vitro biofilm assay was performed to determine the
effect of DispersinB.TM. pre-treatment on the susceptibility of
biofilm-embedded S. epidermidis to CHX. S. epidermidis biofilm
grown in tubes were pretreated with PBS or DispersinB.TM. (20
.mu.g/ml) for 30 min, and then treated with CHX (0.2 .mu.g/ml) for
5 min at 37.degree. C. The untreated, DispersinB.TM. alone, or CHX
alone did not significantly kill S. epidermidis biofilm (FIG. 20).
However, CHX caused a 1.6 log decrease of CFU in tubes pretreated
with DispersinB.TM.. DispersinB.TM. pretreatment made
biofilm-embedded cells more susceptible to CHX. This shows that
sequential application of DispersinB.TM. enzyme and an
antimicrobial agent is possible, when an antimicrobial agent is not
compatible with the enzyme.
Example 21
Increased Susceptibility of Biofilm-Embedded Staphylococcus
epidermidis Pretreated with DispersinB.TM. to Killing by
Benzalkonium Chloride (BKC)
[0240] An in vitro biofilm assay was performed to determine the
effect of DispersinB.TM. pre-treatment on the susceptibility of S.
epidermidis to BKC. S. epidermidis biofilm grown in tubes were
pretreated with PBS or DispersinB.TM. (20 .mu.g/ml) for 30 min, and
then treated with BKC (0.4 .mu.g/ml) for 60 min at 37.degree. C.
The untreated, DispersinB.TM. alone, or BKC alone did not
significantly kill biofilm-embedded S. epidermidis (FIG. 21).
However, BKC caused a 2.2 log decrease in CFU in tubes pretreated
with DispersinB.TM.. DispersinB.TM. pre-treatment made
biofilm-embedded cells more susceptible to BKC. This shows that
sequential application of DispersinB.TM. enzyme and an
antimicrobial agent is possible, when an antimicrobial agent is not
compatible with the enzyme.
Example 22
Enhanced Inhibitory Effect of DispersinB.TM. and EDTA Combination
on Biofilm-Embedded Staphylococcus epidermidis
[0241] An in vitro biofilm assay was performed to determine the
effect of DispersinB.TM. and EDTA on the growth and biofilm
formation of S. epidermidis. The experiment was performed as
explained in Example 1. The 100 ng/ml DispersinB.TM. in combination
with EDTA at two concentrations such as 25 .mu.g/ml and 50 .mu.g/ml
showed enhanced inhibitory effect on S. epidermidis biofilm
formation (FIG. 22).
Example 23
Increased Susceptibility of Biofilm-Embedded Staphylococcus
epidermidis Pretreated with DispersinB.TM. to Killing by Silver
Nanopowder (SNP)
[0242] An in vitro biofilm assay was performed to determine the
effect of DispersinB.TM. pre-treatment on susceptibility of S.
epidermidis to silver nanopowder (SNP). S. epidermidis biofilm
grown in tubes were pretreated with PBS or DispersinB.TM. (20
.mu.g/ml) for 30 min, and then treated with SNP (0.03125 .mu.g/ml)
for 60 min at 37.degree. C. The untreated, DispersinB.TM. alone, or
SNP alone did not significantly kill biofilm-embedded S.
epidermidis (FIG. 23). However, SNP caused a 1.5 log decrease in
CFU in tubes pretreated with DispersinB.TM.. DispersinB.TM.
pre-treatment made biofilm embedded cells more susceptible to SNP
treatment. This shows sequential application of DispersinB.TM.
enzyme and an antimicrobial agent is possible, when an
antimicrobial agent is not compatible with the enzyme.
Example 24
Enhanced Susceptibility of Biofilm-Embedded E. coli to a
Combination Therapy of DispersinB.TM. and Bacteriophage
[0243] An E. coli biofilm, was tested for survival after treatment
with bacteriophage, DispersinB.TM., a bacteriophage cocktail, and a
combination of DispersinB.TM. and a bacteriophage cocktail.
[0244] E. coli TRMG1655 [csrA::kan.sup.8] strain was transformed
with transposon, mini-TN5 luxCDABE::kan.sup.r for luciferase
expression (Kadurugamuwa et al., 2005, Infect. Immun. 73:
3878-3887), and the operon integrated into the chromosome.
Integration was confirmed by amplification of the genomic DNA
upstream of the transposon by inverse PCR using Sspl-digested
genomic DNA. Primers UTCF1 (5'-GTGCAATCCATTAATTTTGGTG-3'; SEQ ID
NO:13) and UTCR (5'-CATACGTATCCTCCAAGCC-3; SEQ ID NO:14) were used
to amplify the upstream region using Pfu DNA polymerase
(Sigma-Oligosynthesis, St. Louis, Mo.). The lux operon is derived
from Photorhabdus luminescence and was obtained from Xenogen Inc.
(Alameda, Calif.). These bioluminescent bacteria allow real-time
monitoring by noninvasive imaging of biofilms, either in vitro or
in vivo.
[0245] A cell suspension of 10.sup.6 E. coli csrA luxCDABE
kan.sup.r was used to inoculate a filter disc (Millipore
Corporation, Billerica, Mass.). The E. coli biofilm was maintained
in minimal media (M9) supplemented with 50 .mu.g/ml kanamycin and
100 .mu.g/ml ampicillin. The media were changed every day by
transferring the disc to new plate. After 3 days, chemoluminescence
activity of the established biofilm was measured using a
Typhoon.TM. imaging scanner (General Electric Healthcare Life
Sciences) and ImageQuant TL software (Amersham Biosciences,
Sunnyvale, Calif.). The measure luminescence directly correlates
with the metabolic activity of the biofilm.
[0246] Luminescence was measured at day 0 and was used as the
control. Following the measurement of luminescence at day 0, each
disc was treated with one of the following--media alone (control)
and media containing:
[0247] 1) 50 .mu.g/ml DispersinB.TM.;
[0248] 2) 10.sup.8 Ff3;
[0249] 3) 10.sup.8 K20;
[0250] 4) 10.sup.8 T7;
[0251] 5) 10.sup.8 U3;
[0252] 6) a phage cocktail of 10.sup.8 of K20, FF3, T7, and U3;
and
[0253] 7) 50 .mu.g/ml DispersinB.TM. plus a phage cocktail of total
10.sup.8 of K20, FF3, T7, and U3.
[0254] Luminescence was measured every 24 hours followed by
replacing the media. Thus, every 24 h following the measurement of
the luminescence, 10 .mu.l each of the different solutions was
applied to the plate and the biofilm disc was placed on top of the
drop everyday. The quantitative analysis of the biofilm
luminescence from each day was used to compare the biofilm activity
after treatment with the different treatments. Table 3 (corresponds
to FIG. 24) provides the raw data as measured in relative light
units (RLU These data show the relative increase or decrease in
luminescence after the particular treatment.
TABLE-US-00005 TABLE 3 Treatment Day 0 Day 1 Day 2 Day 3 Day 4
Control 948.72 1131.8 1135.14 1447.05 1520.07 DispersinB .TM.
948.72 1167.19 1297.42 1487.76 1550.01 DispersinB .TM. + 948.72
24.42 29.48 22.72 18.99 Phage Cocktail Phage Cocktail 948.72 287.82
974.62 1308.72 1381.05 FF3 948.72 252.72 684.26 1072.27 1186.36 K20
948.72 449.21 522.73 742.37 1196.76 T7 948.72 212.8 987.28 1217.28
1457.48 U3 948.72 321.62 803.7 1057.51 1283.72
[0255] The experiments were repeated using the same E. coli strain
csrA IuxCDABE kan.sup.r and protocols. Biofilm discs were pulsed
with media alone (control) and media containing:
[0256] 1) BisEDT (50 .mu.g/ml);
[0257] 2) BisEDT (50 .mu.g/ml) plus a phage cocktail of 10.sup.8 of
K20, FF3, T7, and U3;
[0258] 3) BisEDT (50 .mu.g/ml) plus 50 .mu.g/ml DispersinB.TM.;
[0259] 4.) BisEDT (50 .mu.g/ml) plus 50 .mu.g/ml DispersinB.TM.
plus a phage cocktail of 10.sup.8 of K20, FF3, T7, and U3;
[0260] 5) a phage cocktail of 10.sup.8 of K20, FF3, T7, and U3;
[0261] 6) 50 .mu.g/ml DispersinB.TM.; and
[0262] 7) 50 .mu.g/ml DispersinB.TM. plus a phage cocktail of
10.sup.8 of K20, FF3, T7, and U3.
TABLE-US-00006 TABLE 4 Day 0 Day 1 Day 2 Day 3 Day 4 Control
1815.26 2151.4 1864.41 2318.77 2096.8 BisEDT 1815.26 245.27 83.51
8.02 47.62 BisEDT + Cocktail 1815.26 256.32 25.11 2.53 13.1 BisEDT
+ 1815.26 4.11 32.08 13.35 5.52 DispersinB .TM. BisEDT + 1815.26
0.22 3.16 6.7 22.77 DispersinB .TM. + Cocktail Cocktail 1815.26
188.3 899.35 1485.75 2127.73 DispersinB .TM. 1815.26 2137.73 1911.9
2982.02 2032.06 DispersinB .TM. + 1815.26 287.93 462.37 521.27
429.25 Cocktail
[0263] The data indicate that the combination of DispersinB.TM. and
an antimicrobial agent, including phage), provides a longer term
anti-biofilms effect. Phage therapy alone produces an initially
large decrease in RLU followed by a steady increase over time back
to control levels. However, the combination of DispersinB.TM. and
phage therapy produces a sharp decrease in RLU, which is maintained
over 4 days.
Example 25
Phase Display of DispersinB.TM.
[0264] In the present work, we introduce biofilm dispersal
capabilities to phage by expressing DispersinB.TM. on the phage
surface (phage display of DispersinB.TM.). This allows the
production of DispersinB.TM. at the site of bacterial infections
using phage replication machinery that infect bacteria, and
controls specially targeted pathogenic bacteria. Choosing a lytic
phage for displaying DispersinB.TM. helps to dissolve bacterial
biofilms and facilitate the movement of phage to a host organism.
Conversely, using a temperate phage (lysogenic) for displaying
DispersinB.TM. would not eliminate host bacteria but allow constant
multiplication of phage-displayed DispersinB.TM. at the infection
site and thereby helping to dissolve bacterial biofilm more
rapidly. Once the biofilm is dissolved, the bacteria at the
infection site are easily accessible to antimicrobial compounds and
phages.
[0265] Application of phage-displayed DispersinB.TM. has certain
advantages over purified DispersinB.TM. for infection control. In
general, phages replicate at the site of infection and are
available in abundance where they are most required (Smith &
Huggins, 1982). Use of phage displayed DispersinB.TM. eliminates
time consuming, expensive and elaborate purification process that
is required for production of pure DispersinB.TM.. Purified
DispersinB.TM. has a shelf life of approximately 12 months. Once
phage-displayed DispersinB.TM. is applied to an infection site, the
phase should multiply exponentially using existing host bacteria,
and progressively and effectively dissolve the biofilm by reaching
its deeper layers. As an additional advantage, displaying
DispersinB.TM. on lytic phages facilitates lytic phage to dissolve
biofilm and kill biofilm-embedded bacteria. Furthermore, a
specifically targeted bacterial species can be eliminated and
biofilm can be dissolved by choosing specific lytic phages to
display DispersinB.TM..
[0266] The lytic phage .lamda. and the lysogenic phage M13 are
modified to display DispersinB.TM. on their surfaces to test this
hypothesis.
Materials and Methods
Creation of Recombinant Phage .lamda., M13, and Plasmid Vectors for
DispersinB.TM. Display
[0267] Head decorating protein gene D (gpD) and left arm fragments
(nucleotide position 1-100086, and 20040-33498) of bacteriophage
.lamda., lamB gene of E. coli, rrnB terminator sequence of plasmid
vector pQE60, gene VIII and III sequences of M13 phage,
DispersinB.TM. gene of A. actinomycetemcomitans are amplified by
PCR. Specific restriction sites, linker sequence (GGGSGGGS), and
P.sub.rac sequences are incorporated to PCR fragments with
oligonucleotide primers.
[0268] The pfu DNA polymerase, Klenow fragment of DNA polymerase,
and restriction endonucleases are purchased from MBI Fermentas
(Burlington, ON, Canada). T4 DNA ligase and Shrimp Alkaline
Phosphotase (SAP) are from New England Biolabs (Mississauga, ON,
Canada) and Roche Diagnostics (Laval, QC, Canada), respectively.
Synthetic oligonucleotides are obtained from Sigma Genosys
(Oakville, ON, Canada). All enzymatic reactions and in vitro
packaging a re performed according to manufacturers' instructions.
E. coli cells are transformed by heat shock using frozen competent
cells prepared using calcium chloride method described in Molecular
Cloning (Sambrook et al., 2001). Plasmid DNA is extracted from E.
coli following the alkaline lysis method of Sambrook et al. (1989).
Bacteriophage DNA is extracted following the proteinase K and SDS
method described in Molecular Cloning (2001). A Initially the
recombinant bacteriophage M13-VIII DispersinB.TM. and M13-III
DispersinB.TM. are introduced to host bacteria by
electroporation.
[0269] Plasmid p.sup.QDispersinB.TM.gpD-1 and
p.sup.QgpDDispersinB.TM.-2 are high copy number plasmids with
cloned DispersinB.TM. fused to the N-terminus and C-terminus,
respectively, of gpD gene and expression is controlled in both
plasmids by the P.sub.csc promoter (FIG. 25). To aid purification
of the fusion protein, the DispersinB.TM. gene in vectors
p.sup.QDispersinB.TM.gpD-1 and p.sup.QgpDDispersinB.TM.-2 carry a
histidine tag (6.times.His) at their N- and C-terminus,
respectively. .lamda.DispersinB.TM.gpD.sup.-1 and .lamda.gpD
DispersinB.TM..sup.-2 develop by incorporating promoterless
DispersinB.TM.-gpD and gpD-DispersinB.TM. fusion cassettes
p.sup.QDispersinB.TM.gpD-1 and p.sup.QgpDDispersinB.TM.-2,
respectively. In both .lamda. DispersinB.TM. gpD.sup.-1 and
.lamda.grpD DispersinB.TM..sup.-2, the expression of the
DispersinB.TM. fusion peptide is under the expression signal of the
original gpD promoter. Since the gpD gene of phase .lamda.
DispersinB.TM. gpD.sup.-1 and .lamda.gpD DispersinB.TM..sup.-2 are
replaced with DispersinB.TM.-gpD, 100%; of head decorating protein
molecules carry DispersinB.TM. as a displayed protein. Phage
.lamda.gpD- is defective in infection since the gpD gene is
deleted. .lamda.gpD- can become infective by trans supply of the D
protein. Therefore, .lamda.gpD- is used for screening expression
cassettes (i.e. p.sup.QDispersinB.TM.gpD-1,
p.sup.QgpDDispersinB.TM.-2, p.sup.QDispersinB.TM.gpD-3,
p.sup.QgpDDispersinB.TM.-4) that produce the DispersinB.TM.-gpD
fusion (FIGS. 25 and 26). Plasmids p.sup.B8LDSVIII and
P.sup.B3LDSIII are high copy number plasmids that carry
DispersinB.TM. inserted between the leader sequence and the
sequence that codes for the mature protein of coat proteins VIII
and III, respectively, of phage M13 (FIG. 27). Both expression
cassettes are under the control of the P.sub.tac promoter, and the
rrnB terminator sequence is placed before the P.sub.tac promoter to
terminate any transcription from upstream promoters. To aid
purification of the fusion protein, the DispersinB.TM. gene in
vectors p.sup.B8LDSVIII and P.sup.B3LDSIII carry a histidine tag
(6.times.His) at their N terminus. Phage M13-VIII DispersinB.TM.
and M13-III DispersinB.TM. carry the DispersinB.TM. expression
cassettes of p.sup.B8LDSVIII and P.sup.B3LDSIII respectively (FIG.
27). Since both phages M13-VIII DispersinB.TM. and M13-III
DispersinB.TM. also carry their wild type copy of genes VIII and
III, only a fraction of major coat protein VIII and minor coat
protein III of M13-VIII DispersinB.TM. and M13-III DispersinB.TM.,
respectively, are fused to DispersinB.TM..
Growth of Bacteria and Phage
[0270] All bacterial strains are cultured at 37.degree. C. with
agitation at 200 rpm in LB medium that contains 10 g/L each of
bactotryptone, 10 g/L sodium chloride, and 5 g/L yeast extract in
prepared in distilled deionized water.
[0271] Stocks of M13 phages are prepared by first inoculating 20 ml
LB culture with 1 ml from a fresh overnight culture of host
bacteria. The culture is shaken for 1 hr, after which 10.sup.10
plaque forming units (pfu) of the phage are added and the culture
is shaken for an additional 3 hrs. The culture is cleared by
centrifugation, and phage are precipitated by addition of 4% (w/v)
polyethylene glycol (PEG) 8000 and 3% NaCl (w/v), incubating on ice
for 1 hr, and centrifugation at 10000 rpm for 30 min. The phage
pellet is resuspended in 1 ml PBS (50 mM phosphate, pH 7.2, 150 mM
NaCl) and is microcentrifuged to pellet the debris. The supernatant
containing phage is transferred to new tube.
[0272] Stocks of .lamda. phages are prepared by infecting 0.1 ml
fresh overnight culture of host bacteria cultured in LB with
10.sup.6 pfu of the phage in 50-100 .mu.l volume. The infected
culture is incubated for 20 min at 37.degree. C. in 4 ml of LB with
vigorous shaking until the cells are completely lysed, usually for
8-12 hrs. The lysate is supplemented with 100 .mu.l of chloroform,
incubating for 15 minutes at 37.degree. C., and is centrifuged at
4000 g for 10 minutes at 4.degree. C. The supernatant containing
phage is separated and further purified by centrifugation through a
glycerol step gradient (40% & 5%) at 35000 rpm for 60 minutes
at 4.degree. C.
[0273] The concentration of phage in final stocks is determined by
extracting DNA and subjecting the samples to electrophoresis on 1%
agarose gels, where known quantities of similar DNA is used as
standards. Plaque-forming units per ml are calculated with soft
agar overlay method.
Purification of DispersinB.TM. and DispersinB.TM.-Phage Fusion
Proteins
[0274] E. coli Tuner (DE3)pLacI are transformed with plasmids
expressing DispersinB.TM.. A single colony carrying transformed
plasmid is cultured in 500 ml LB media containing 50 mg/L
ampicillin and used for extraction of DispersinB.TM.. Bacterial
cells are harvested by centrifugation at 5000 rpm for 15 minutes,
and the cell pellet is taken up in 20 ml of lysis buffer (20 mM
Tris-HCl (pH 8.0, 500 mM NaCl, 1 mM PMSF, 2 mg/ml lysozyme 0.1%
Igepal.RTM.). Cells are disrupted by sonication three limes, each
10 seconds at 30% capacity. The cell lysate is supplemented with
RNaseA and DNaseI to a final concentration of 10 .mu.g/ml and 5
.mu.g/ml, respectively, and is incubated for 30 minutes at zoom
temperature with gentle agitation. The cell debris is pelleted by
centrifugation at 13000 rpm for 30 minutes, and the cleared lysate
is used for isolation of DispersinB.TM. by Ni-affinity
chromatography. The clear cell lysate is passed through a column
packed with Ni-CAM.TM. HC Resin (10 cm pack volume) and is
equilibrated with wash buffer (20 mM Tris-HCl (pH 8.0), 500 mM
NaCl). The column is washed with 3 column volumes of wash buffer
containing 5 mM imidazole followed by another 3 column volumes of
wash buffer containing 20 mM imidazole. DispersinB.TM. is eluted in
one ml fractions with 20 ml elution buffer (wash buffer containing
100 mM imidazole). DispersinB.TM. containing fractions are pooled
and dialyzed against 4 L of 100 mM phosphate buffer (pH 5.9)
containing 200 mM NaCl. Purified DispersinB.TM. is stored in
storage buffer (50 mM Phosphate buffer (pH 5.9), 50 mM NaCl, 50%
Glycerol) at -20.degree. C.
DispersinB.TM. Enzyme Assay
[0275] The activity of DispersinB.TM. displayed on phage and
purified DispersinB.TM. fusion peptides is measured by following
the .beta.-1,6-N-acetyl D-glucosaminidase (DispersinB.TM.) assay as
described by Kaplan et al. (2003, J. Bacteriol. 185: 4693-4698).
The enzyme reaction is carried out in total 1 mL reaction volume
that contains 500 .mu.l of 10 mM substrate stock (5 mM
4-nitrophenyl N-acetyl-D-glucosaminide), 3.7 .mu.g DispersinB.TM.
solution or known volume of purified DispersinB.TM. display phage,
50 mM sodium phosphate buffer pH 5.9 containing 100 mM NaCl and
ddH.sub.20 to bring the total reaction volume to 1 ml. The reaction
mix is incubated at 30.degree. C. for 30 min and supplemented with
5 .mu.l of 10 N NaOH to stop enzyme reaction. The amount of
p-nitrophenol produced in the reaction is determined
spectrophotometrically at 405 mm using a standard curve
constructed.
Cell Count Assay
[0276] A fresh overnight culture of bacteria grown in LB is diluted
to 5% in LB, and 1.8 ml is added per well of 12-well tissue culture
polystyrene plates (Corning Inc., New York, N.Y.). 200 .mu.l of
different dilutions of an aqueous test solution containing purified
DispersinB.TM. or its fusion peptides or phages with or without
displayed DispersinB.TM. are added per well individually. 200 .mu.l
Water is added to negative control wells. After incubating for 24
hrs, the medium containing planktonic cells in each well is
removed, and the biofilm is rinsed with PBS. After adding 2 ml of
PBS to each well, the plate is sonicated for 1 minute, and the
dislodged biofilm is mixed well with the pipette tip. The 1 ml
suspension from each well is then serially diluted and 100 .mu.l
aliquots from each dilution are inoculated to LB plates. The plates
are incubated at 37.degree. C. for 24 hrs, and colonies are
enumerated. Biofilm assay Fresh overnight grown cultures are
diluted to 5% in LB medium, and 180 .mu.l are added to each well of
a 96-well microtitre plate (Corning Inc.). 20 .mu.l of different
dilutions of an aqueous test solution containing purified
DispersinB.TM. or DispersinB.TM.-phage fusion peptides or phages
with or with out displayed DispersinB.TM. are added to microtiter
plate wells individually. dd H.sub.2O serves as control. The plates
are incubated at 37.degree. C. for 16-18 h under stationary
condition and the growth is measured at 600 nm. Biofilm formation
is determined by measuring the absorbance at 630 nm. Biofilms are
assayed by crystal violet staining, as described by Jackson et al.
(2002, J. Bacteriol. 184: 290-301.).
Example 26
DispersinB.TM. in Combination with Detergents
[0277] A major component of the A. actinomycetemcomitans biofilm
matrix is a hexosamine-rich polysaccharide that is functionally and
genetically related to extracellular polysaccharide adhesins
produced by S. aureus, S. epidermidis, E. coli and A.
pleuropneumoniae (Kaplan et al., 2004). These polysaccharides,
usually referred to as PNAG, PIA (polysaccharide intercellular
adhesin), or PGA, consist of linear chains of
N-acetyl-D-glucosamine (GlcNAc) residues in .beta.(1,6) linkage
(hereafter referred to as PGA). PGA has been shown to play a role
in abiotic surface attachment and intercellular adhesion (Wang et
al., J. Bacteriol. 186: 2724-2734 (2604); Izano et al., Microb.
Pathogen. 43: 1-9 (2007); Agladze et al., J. Bacteriol. 187:
8237-8246 (2005); Heilmann et al., Mol. Microbiol. 20: 1083-1091
(1996); McKenny et al., Infect. Immun. 66: 4711-4720 (1998)),
protection from killing by antibiotics, antimicrobial peptides and
phagocytes (Izano et al., 2007; Vuong et al., Cell. Microbiol. 6:
269-275 (2004)) and virulence (Kropec et al., Infect. Immun. 73:
6868-6876 (2005)). In A. actinomycetemcomitans, PGA has been shown
to mediate intercellular adhesion and resistance to killing by the
anionic detergent sodium dodecyl sulfate (SDS) (Kaplan et al,
2004).
[0278] The effect of a detergent on the sensitivity of
biofilm-embedded A. actinomycetemcomitans was investigated.
Methods
[0279] Reagents. Recombinant dispersinB protein was purified from
an overexpressing strain of E. coli as previously described (Kaplan
et al., J. Bacteriol. 2003, 185: 4693-4698). The enzyme had a
specific activity of .about.10.sup.3 units per mg of protein.
Sodium dodecyl sulfate (SDS) was purchased from Fluky (St. Gallen,
Switzerland). Phosphate-buffered saline (PBS; 138 in M NaCl, 10 mM
phosphate, 2.7 mM KCl, pH 7.4) was purchased from Sigma Chemical
Company (St. Louis, Mo., USA).
[0280] Bacterial strains, media, and growth conditions. A.
actinomycetemcomitans strain CU1000 (serotype f) was isolated from
a 13-year-old African-American female with localized aggressive
periodontitis (Fine et al., Microbiol. 1999, 145: 1335-1347).
Strain CU1000 exhibits a rough-textured colony morphology on agar
and a strong biofilm formation phenotype in broth, both of which
are characteristic of fresh clinical isolates (Fine et 1999). An
isogenic PGA mutant strain HW1018. (CU1000 pgaC::IS903.phi.Kan) was
isolated by randomly mutagenizing CU1000 with transposon
IS903.phi.Kan and selecting mutants that produced white colonies on
Congo red agar, as previously described (Kaplan et al., 2003;
Kaplan et al., J. Bacteriol. 2004, 186: 8213-8220). Like other pgaC
mutant strains, HW1018 was completely deficient in PGA production,
but still fanned tenacious biofilms on plastic surfaces (Kaplan et
al., 2004). Bacteria were grown in trypticase soy broth
supplemented with 6 g yeast extract and 8 g/L glucose. Solid medium
was supplemented with 15 g/L agar. All cultures were incubated
statically at 37.degree. C. in 10% CO.sub.2.
[0281] Preparation of Inocula. Approximately 10 colonies from a
4S-hour-old agar plate were transferred to a 1.5-mL polypropylene
microcentrifuge tube containing 200 .mu.L of fresh broth. The cells
were homogenized with 10 strokes of a disposable pellet pestle
(Kontes), transferred to a 15-mL conical centrifuge tube containing
2 mL of fresh broth, subjected to high-speed vortex agitation for
15 sec, and then passed through a 5-.mu.m-pore-size PVDF syringe
filter (Millipore). The resulting filtrate 1 mL) contained >99%
single cells at a concentration of 10.sup.7 to 10.sup.8
colony-forming units (CFU)/mL (Kaplan & Fine, Appl. Environ.
Microbiol. 2002, 68: 4943-4950).
[0282] Biofilm Cultures. Bio films were grown in 17 mm.times.100
min culture tubes (untreated polystyrene; Falcon #352051) or
96-well microtiter plates (tissue culture-treated polystyrene, flat
bottoms; Falcon #353072). Culture vessels were inoculated with a
1:10 dilution of inoculum in fresh broth (1 ml, for tubes or 200
.mu.l for microplates) and incubated for 24 h.
[0283] Crystal Violet Assay. Biofilm biomass was visualized and
quantitated by means of a crystal violet binding assay as
previously described (Kaplan et al., Antimicrob. Agents Chemother.
2004, 48: 2633-2636). Briefly, biofilms were rinsed with water to
remove loosely attached cells, stained for 1 min with Gram's
crystal violet (200 .mu.L for microplates and 1 mL for tubes),
rinsed, dried, and photographed. For quantitation of biofilms grown
in microplates, biofilms were de-stained with 200 .mu.L of 33%
acetic acid for 5 min, and the absorbance of the crystal violet
solution was measured directly in the plate by means of a BioRad
Benchmark microtiter plate-reader set at 590 nm. Crystal violet
binds to bacterial biofilms, but not to polystyrene (O'Toole &
Kolter, Mol. Microbiol. 1998, 28: 449-461).
[0284] Biofilm Detachment Assay. Biofilms were rinsed with water
and treated with 200 .mu.L (for microplates) or 1 ml, (for tubes)
of DispersinB.TM. (20 .mu.g/mL in PBS) or SDS (0.001-1% in PBS).
After a five- or 30-minute incubation at 37.degree. C., biofilms
were rinsed with water and stained with crystal violet as described
above. In some assays, biofilms were first treated with
DispersinB.TM. for 5 or 30 min, rinsed, and then treated with SDS.
All detachment assays were performed in duplicate wells or tubes.
All assays were performed on at least 3 separate occasions, with
similar results.
[0285] Biofilm Killing Assay. Biofilms grown in polystyrene tubes
as described above were washed 3 times with sterile PBS and then
treated with 1 mL of SDS (0.01% in PBS) or cetylpyridinium chloride
(CPC; 0.02% in PBS). After 5 min, the bio films were rinsed 3 times
with PBS to remove the SDS or CPC, and then treated with 1 mL of
DispersinB.TM. (20 .mu.g/mL in PBS) for 5 min to detach the cells.
Tubes were vortexed for 10 s, and 20 .mu.L aliquots of the detached
biofilms were transferred to the wells of a flat-bottomed 96-well
microtiter plate containing 180 .mu.L of fresh broth. Five serial
dilutions (20 .mu.L into 180 .mu.L) were performed directly into
adjacent wells. Plates were incubated for 48 h and then rinsed and
stained with crystal violet as described above. Wells containing
30-300 biofilm colonies were photographed under a dissecting
microscope and counted. In some assays, biofilms were pre-treated
with 1 mL of DispersinB.TM. (20 .mu.g/mL in PBS) for 5 mM prior to
the SDS treatment. In these assays, a 100 .mu.l quantity of SDS in
PBS (at 10 times the test concentration) was added directly to the
DispersinB.TM.-treated cell suspension and mixed. After 5 min,
tubes were vortexed briefly, and 20-.mu.L aliquots of culture were
enumerated as described above. Killing assays were performed in
duplicate tubes on at least 5 separate occasions, with similar
results.
Detachment of Biofilms by SDS and DispersinB.TM.
[0286] Crystal violet dye was used to visualize A.
actinomycetemcomitans biofilm growth and detachment in polystyrene
tubes and 96-well microtiter plates (FIG. 28). Both wild-type and
PGA mutant strains formed uniform biofilms that covered the bottom
surface of the tube or microplate well after 24 hrs (FIGS. 28A,
28B). In all cultures, the broth remained optically clear and
contained <1% of the total CPUs after 24 hrs.
[0287] A solution of 0.1% SDS had no effect on the attachment of
wild-type biofilms, but caused the rapid detachment of PGA mutant
biofilms, in both tubes and microplate wells (FIGS. 30A, 30B). In
contrast, a solution of 20 .mu.g/mL of DispersinB.TM. caused the
rapid detachment of wild-type biofilms from tubes, but not from
microplate wells. DispersinB.TM. had no effect on the attachment of
PGA mutant biofilms grown in either culture vessel. Microscopic
analyses of biofilms grown in tubes indicated that DispersinB.TM.
caused the biofilms to disaggregate into uniformly turbid
suspensions containing >99% single cells, with very few small
clusters of cells (data not shown). Detachment of biofilms from
microplate wells could be achieved if higher DispersinB.TM.
concentrations and longer incubation times were used (Kaplan et
al., J. Bacteriol. 2003, 185: 4693-4698).
[0288] Pre-treatment of wild-type biofilms with DispersinB.TM.
rendered them sensitive to detachment by SDS in microplate wells
(FIG. 28C). Biofilms were treated with 0-001-1% SDS for 5 min and
then biofilm biomass was quantitated by measuring the amount of
bound crystal violet dye to measure the concentration of SDS needed
to detach A. actinomycetemcomitans biofilms from microplate wells
(FIG. 29). Wild-type biofilms were resistant to detachment at all
concentrations of SDS. A slight, but reproducible, increase in
crystal violet staining was exhibited by biofilms treated with
0.04-0.11% SDS. In contrast, wild-type biofilms pre-treated with
DispersinB.TM. were resistant to detachment only at SDS
concentrations <0.04%. When the concentration of SDS was
increased from 0.04 to 0.07%, biofilms underwent a transition from
SDS-resistant to SDS-sensitive. This concentration of SDS (1.4-2.4
mM) is very close to the critical micelle concentration (CMC) of
SDS in physiologic saline at 37.degree. C. (Helenius et al.,
Methods Enzymol. 1979, 56: 734-749). PGA mutant biofilms exhibited
a nearly identical transition from SDS resistant to SDS-sensitive
between 0.04 and 0.07% SDS (data not shown).
DispersinB.TM. Increases the Sensitivity of Biofilms to Killing by
SDS
[0289] The sensitivity of A. actinomycetemcomitans biofilms to
killing by 0.01% SDS was tested. The 0.01% SDS corresponds to the
MIC against A. actinomycetemcomitans planktonic cells (Drake et
al., J. Periodontal. 1992, 63: 696700; Wade & Addy, J.
Periodontal. 1992, 63: 280-282), but which is below the
concentration required for biofilm detachment (FIG. 29). Biofilms
grown in tubes were pre-treated with PBS (mock pre-treatment) or
DispersinB.TM. for 5 min or 30 min, and then treated with SDS for 5
min. PBS, DispersinB.TM., or SDS alone did not significantly kill
A. actinomycetemcomitans biofilms (FIG. 30). However, SDS caused a
2-log-unit decrease in the number of CFU in tubes pre-treated with
DispersinB.TM. for 5 min, and a 4-log-unit decrease in tubes
pre-treated for 30 min.
DispersinB.TM. Increases the Sensitivity of Biofilms to Killing by
CPC
[0290] The sensitivity of A. actinomycetemcomitans biofilms to
killing by 0.02% cetylpyridinium chloride (CPC) was tested. The
0.02% CPC corresponds to 10 times the MIC against A.
actinomycetemcomitans planktonic cells, but which is below the
concentration required for biofilm detachment (data not shown). Bio
films grown in tubes were pretreated for 30 min with phosphate
buffer saline (PBS; mock pretreatment) or PBS with 20 .mu.g/mL of
DispersinB.TM., and then treated with 0.02% CPC for 5 min. Biofilms
treated with DispersinB.TM. or CPC alone exhibited little or no
reduction in the number of CFU/tube compared to the mock-treated
controls (FIG. 31). Biofilms treated with DispersinB.TM. and then
CPC, however, exhibited an approximately 3 log unit decrease in the
number of CPUs/tube compared to biofilms treated with
DispersinB.TM. or CPC alone.
[0291] These findings suggest that DispersinB.TM. is a useful agent
for sensitizing biofilms to detachment and killing by a detergent
such as SDS or CPC, and/or other antimicrobial agents.
Example 27
Formulation of DispersinB.TM. Antimicrobial Wound Gel
[0292] As a general procedure, finely powdered sodium alginate (the
use of other alkaline metal alginates may also be considered) was
blended with DispersinB.TM. in distilled water at room temperature
for 6-8 hours. As the alginate slowly dissolved and absorbed water,
a gel began to form. Stirring continued during this process so that
as any yet unblended alginate did not settle out. The final
formulation of wound gel contained 0.01% DispersinB.TM., 1.5%
sodium alginate, and 98.49% water.
Example 28
Formulation of Triclosan-DispersinB.TM. Antimicrobial Wound Gel
[0293] The solvent system for triclosan comprising polyethylene
glycol, ethanol was prepared in distilled water. Triclosan was
dissolved in solvent system at 65.degree. C. with stirring for 8-10
hours. The solution was cooled to room temperature, and
DispersinB.TM. along with sodium alginate was added. The gel was
formed as explained in Example 27. The final gel formulation
contained 1% triclosan, 10% polyethylene glycol 400, 10% ethanol,
0.01% DispersinB.TM., 1.5% sodium alginate and 77.49% water.
Example 29
Effect of DispersinB.TM. Antimicrobial Wound Gel on Staphylococcus
epidermidis Biofilm Formation
[0294] An in vitro microtiter assay was performed to determine the
effect of DispersinB.TM. wound gel on the growth and biofilm
formation of Staphylococcus epidermidis. S. epidermidis biofilm was
grown in tryptic soy broth (TSB). S. epidermidis was grown in
96-well microtiter plate in the absence and presence of
DispersinB.TM. wound gel at different concentrations. The plate was
incubated at 37.degree. C. for 24 hours. Growth of planktonic cells
based on the absorbance at 600 nm was determined using Labsystems
Multiskan Ascent microplate reader. Biofilm was measured by
discarding the medium, rinsing the wells with water (three times),
and staining bound cells with crystal violet. The dye was
solubilized with 33% acetic acid, and absorbance at 630 nm was
determined. For each experiment, background staining was corrected
by subtracting the crystal violet bound to uninoculated control
(FIG. 32). The test showed 65%-80% biofilm inhibition at all wound
gel dilutions tested without affecting planktonic growth.
Example 30
Effect of DispersinB.TM. Antimicrobial Wound Gel on Staphylococcus
epidermidis Biofilm Dispersal
[0295] An in vitro microtiter assay was performed to determine the
effect of DispersinB.TM. wound gel on the dispersal of
Staphylococcus epidermidis biofilm. S. epidermidis biofilm was
grown in tryptic soy broth (TSB). S. epidermidis was grown in
96-well microtiter plate at 37.degree. C. for 24 hours. The
planktonic growth was discarded and the biofilm was treated with
serial two-fold dilutions of DispersinB.TM. wound gel at 37.degree.
C. for 3 hours. After wound gel treatment the microtiter plate was
washed and stained as explained in example 2. The test showed
57%-75% S. epidermidis biofilm dispersal at all wound gel dilutions
tested (FIG. 33).
Example 31
Antimicrobial Activity of Triclosan-DispersinB.TM. Antimicrobial
Wound Gel Against Wound Associated Pathogens
[0296] The antimicrobial activity of Triclosan-DispersinB.TM. was
tested in vitro, against wound-associated bacteria such as
Staphylococcus aureus, S. epidermidis, Enterococcus faecalis,
Escherichia coli, Enterobacter cloacae, and yeast Candida albicans
(Vandenbulcke, et al. 2006. Lower Extremity Wounds, 5: 109-114).
The organisms were incubated on Trypticase Soy Agar and the plates
were overlayed with 100 .mu.l of wound gel. The plates were
incubated at 37.degree. C. for 24-48 hours. The number of colony
forming units (CPU) per milliliter for each culture was calculated
(Table 5). Unexpectedly, there was zero growth (no CRT) on any of
the TSA plates treated with Triclosan-DispersinB.TM. wound gel.
TABLE-US-00007 TABLE 5 Effect of Triclosan-DispersinB .TM.
antimicrobial wound gel on growth of wound-associated pathogens
CFU/ml Pathogen Untreated Treated Gram-positive bacteria
Staphylococcus aureus 1.2 .times. 10.sup.8 0 S. epidermidis 1
.times. 10.sup.8 0 Enterococcus faecalis 2.3 .times. 10.sup.8 0
Gram-negative bacteria Escherichia coli 2.2 .times. 10.sup.8 0
Enterobacter cloacae 1.5 .times. 10.sup.8 0 Yeast Candida albicans
4.5 .times. 10.sup.6 0
Example 32
Inhibitory Effect of DispersinB.TM. and Triclosan (TCSN)
Combination on Staphylococcus epidermidis Biofilm
[0297] In vitro microplate assay was performed to determine the
synergistic effect of DispersinB.TM. and triclosan (an
antimicrobial agent) on the growth and biofilm formation of S.
epidermidis. Overnight culture of S. epidermidis in Tryptic Soy
Broth (TSB) was used as inoculum. Bacteria were grown in TSB on a
96-well microtiterplate in the absence and presence of each
compound (DispersinB.TM. or TCSN) at different concentrations
separately and together (DispersinB.TM.+TCSN). The plate was
incubated at 37.degree. C. for 24 hours. Growth of planktonic cells
based on the absorbance at 600 nm was determined using Labsystems
Multiskan Ascent microplate reader. Biofilm was measured by
discarding the medium; rinsing the wells with water (three times)
and staining bound cells with crystal violet. The dye was
solubilized with 33% acetic acid, and absorbance at 630 nm was
determined using a microtiter plate reader. For each experiment,
background staining was corrected by subtracting the crystal violet
bound to uninoculated control. The combination of DispersinB.TM.
and TCSN (50 ng/ml+50 .mu.g/ml, respectively) showed inhibitory
effect on S. epidermidis biofilm formation (FIG. 34).
Example 33
Inhibitory Effect of DispersinB.TM. and Triclosan (TCSN)
Combination Coated Silicone Catheters on Staphylococcus epidermidis
and Esherichia coli Colonization
[0298] The adhesion assay was performed to determine the
synergistic effect of DispersinB.TM. and TCSN combination coated
silicone catheters on S. epidermidis and E. coli colonization. The
silicone catheter segments (1 cm each) were coated by dipping in
DispersinB.TM. (40 .mu.g/ml) and TCSN (10 mg/ml in 10% Polyethylene
glycol) alone and in combination for overnight at 4.degree. C.
followed by drying at room temperature. The coated and uncoated
segments were incubated in S. epidermidis and E. coli culture in
TSB medium at 37.degree. C. for 24 hours at 100 rpm. After 24 hours
of incubation, the sections were washed three times gently. Each
washed section was transferred into a sterile tube containing 1 ml
sterile saline and subjected to sonication for 30 seconds and
followed by 1 minute vortexing. Further, it was serially diluted
using sterile saline and plated using Tryptic Soy Agar (TSA)
plates. The plates were incubated at 37.degree. C. for 24 hours and
the colonies (CPU) were counted. Although triclosan was more
effective than DispersinB.TM. in inhibiting the growth of
biofilm-embedded S. epidermidis and E. coli, the combination-coated
catheters showed an enhanced anti-adherence effect on S.
epidermidis and E. coli (FIGS. 35 and 36).
Example 34
Antibiofilm Activity of DispersinB.TM. and Triclosan (TCSN)
Combination-Coated Catheters Against Catheter-Associated
Microorganisms
[0299] The broad-spectrum antibiofilm activity of DispersinB.TM.
and TCSN combination coated catheters against catheter-associated
bacteria and yeast was determined. Catheter-associated
microorganisms such as E. coli, Proteus mirabilis, Pseudomonas
aeruginosa, Klebsiella pneumoniae, Enterococcus faecalis,
Enterococcus cloacae, Citrobacter diversus, S. epidermidis,
Staphylococcus aureus, Staphylococcus saprophyticus, and Candida
albicans were grown in TSB for 18 hours. The catheter coating and
adherence assay for 24 hours were done as described in Example 33.
The TCSN-DispersinB.TM. combination coated catheters were
broad-spectrum in terms of inhibiting Gram +ve, Gram -ve bacteria
and yeast colonization on catheters (FIG. 37). The
combination-coated catheters inhibited >90% colonization of
catheters by test organisms, except Enterococcus faecalis.
Example 35
Durability of Inhibitory Activity of DispersinB.TM. and Triclosan
(TCSN) Combination-Coated Polyurethane Catheters
[0300] The durability of inhibitory activity of DispersinB.TM.+TCSN
coated 1 cm polyurethane catheter segments was assessed using
Kirby-Bauer technique as previously described by Sheretz et al.
(Antimicrob. Agents Chemother., 33: 1174-1178, 1989). The catheters
were coated as described in Example 2. The test organisms such as
Staphylococcus aureus and Staphylococcus epidermidis were grown in
TSB for 18 hours at 37.degree. C. An appropriate inoculum of each
bacterial strain was used to prepare spread plates. The coated
catheter segments were carefully plated. Following incubation for
24 hours at 37.degree. C., the zones of inhibition surrounding each
segment were measured at the aspects of perpendicular to the long
axes. After measuring the zone of inhibition, the segments were
transferred onto fresh spread plates inoculated with respective
test organism and incubated for 24 hours at 37.degree. C. again.
The zones of inhibitions were measured again. This procedure was
repeated for determining the durability of inhibitory activity of
coated catheter sections against S. aureus and S. epidermidis (FIG.
38). The coated segments showed significant inhibitory activity
against S. aureus and S. epidermidis even after 14 days of
passage.
Example 36
Durability of Inhibitory Activity of DispersinB.TM. and Triclosan
(TCSN) Combination-Coated Polyurethane Catheters in Plasma (Tested
Against Staphylococcus epidermidis)
[0301] The ability of DispersinB.TM.-TCSN coated polyurethane
catheters to resist bacterial colonization for a period of 7 days
was tested by exposing uncoated and coated segments to S.
epidermidis. The coated and uncoated catheter segments were
incubated in rabbit plasma at 37.degree. C. separately for 7 days
at 100 rpm prior to challenging with S. epidermidis. Both coated
and uncoated catheter segments (in triplicate) were removed at time
intervals of 1, 5 and 7 days. Further, they were challenged with S.
epidermidis one at a time. Following the incubation, the catheter
segments were rinsed 3 times gently with sterile water. Each washed
segment was transferred into sterile tube containing 1 ml sterile
saline and subjected to sonication for 30 seconds followed by 1
minute vortexing. Further, it was serially diluted and plated on
TSA. The plates were incubated at 37.degree. C. for 24 hours and
colony-forming units (CFU) were counted. This procedure was
repeated for each time interval. The DispersinB.TM.-TCSN coated
catheter segments were effective in preventing S. epidermidis
biofilm formation over a period of 7 days (FIG. 39).
Example 37
Durability of Inhibitory Activity of DispersinB.TM. and Triclosan
(TCSN) Combination-Coated Polyurethane Catheters in TSB Containing
20% Bovine Serum (Tested Against Staphylococcus aureus)
[0302] The ability of DispersinB.TM.-TCSN coated polyurethane
catheters to resist bacterial colonization and retain antimicrobial
activity for a period of 7 days was tested by exposing uncoated and
coated segments to S. aureus. The coated and uncoated segments were
incubated in TSB containing 20% bovine serum for 7 days at 100 rpm.
The TSB containing 20% bovine serum was replaced every 24 hour. The
anti-adherence activity was performed as explained in Example 36.
After 7 days of incubation, the coating prevented >99% S. aureus
biofilm formation (FIG. 40). The antimicrobial activity and
durability was assessed using Kirby-Bauer technique as previously
described by Sheretz et al. (Antimicrob. Agents Chemother., 33:
1174-1178, 1989). Both coated and uncoated catheter segments (in
triplicate) were removed at time intervals of 1, 5 and 7 days. S.
aureus was grown in TSB for 18 hours at 37.degree. C. An
appropriate inoculum of bacterial strain was used to prepare spread
plates. The coated catheters were carefully plated. Following
incubation for 24 hours at 37.degree. C., the zones of inhibition
surrounding each segment were measured at the aspects of
perpendicular to the long axes. This procedure was repeated for
each time interval (FIG. 41). The coated catheter segments retained
antimicrobial activity even after 7 days of incubation in TSB
containing 20% bovine serum.
Example 38
Durability of Inhibitory Activity of DispersinB.TM. and Triclosan
(TCSN) Combination-Coated Silicone Catheters in Synthetic Urine
(Tested Against Staphylococcus epidermidis)
[0303] The ability of DispersinB.TM.-TCSN coating on silicone
catheters to resist bacterial colonization and retain antimicrobial
activity for 10 days was tested by exposing the uncoated and coated
segments to test organisms. The coated and uncoated catheter
segments were incubated in sterile artificial urine medium at
37.degree. C. for 10-14 days at 100 rpm. The artificial urine in
the flask was replaced with fresh artificial mine every 24 hours.
Both coated and uncoated catheter segments (in triplicate) were
removed at lime intervals of 1, 4, 7, 10 and 14 days. Further, they
were challenged with S. epidermidis one at a time. Following the
incubation, the catheter sections were rinsed 3 times gently with
sterile water. Each washed segment was transferred into sterile
tube containing 1 ml sterile saline and subjected to sonication for
30 seconds followed by 1 minute vortexing. Further, each section
was serially diluted and plated on TSA. The plates were incubated
at 37.degree. C. for 24 hours and colony-forming units (CFU) were
counted. This procedure was repeated for each time interval. The
DispersinB.TM.-TCSN coated catheter segments were effective in
preventing S. epidermidis biofilm formation for more than 10 days
(FIG. 42). The antimicrobial activity retained by the catheters was
studied by Kirby-Bauer technique as previously described by Sheretz
et al. (Antimicrob. Agents Chemother., 33: 1174-1178, 1989) against
E. coli, P. mirabilis, K. pneumoniae and S. epidermidis. The coated
catheter segments showed a significant inhibitory activity against
E. coli, P. mirabilis, K. pneumoniae and S. epidermidis even after
14 days (FIG. 43).
Example 39
In Vivo Efficacy of DispersinB.TM.+Triclosan (DispersinB.TM.+TCSN)
Coated Central Venous Catheters (CVC)
[0304] In vivo efficacy study was conducted using rabbits to
determine the rates of catheter colonization and catheter related
infections by Staphylococcus aureus with the following four groups
of CVCs: (i) catheters coated with DispersinB.TM.+TCSN, (ii)
catheters coated with chlorohexidine+silver sulfadiazine (CH/SS),
(iii) chlorohexidine+silver sulfadiazine plus (CH/SS plus), and
(iv) uncoated catheters. Thirty 1-cm segments of CVCs from each
group were implanted subcutaneously in the back of a total of 20
female New-Zealand whit; specific pathogen-free rabbits. Each
catheter insertion site was inoculated with 10.sup.4 colony forming
units (CPU) of clinical isolate of S. aureus. After 7 days, the
rabbits were sacrificed; the catheters were explanted, and cultured
by plating on agar plates. Out of 30, 29 (96.7%) uncoated, 1 (3.3%)
DispersinB.TM.+TCSN coated, 4 (13.3%) CH/SS coated and 1 (3.3%)
CH/SS plus coated catheters were colonized by S. aureus (FIG. 44).
The DispersinB.TM.+TCSN, CH/SS and CH/SS plus catheter coatings
significantly reduced catheter colonization by S. aureus
(p.ltoreq.0.001) compared to uncoated catheter.
Example 40
Enhancing Effect of DispersinB on the Sensitivity of
Biolfilm-Embedded Staphylococcus epidermidis to Xylitol
[0305] An in vitro biofilm-dispersal assay was performed to
determine the enhancing effect of DispersinB.TM. on the sensitivity
of biofilm-embedded S. epidermidis to xylitol. S. epidermidis
biofilm was grown in 1.5 ml polypropylene microcentrifuge tubes
(200 .mu.l culture volume) for 24 h and medium containing
planktonic cells was discarded. Further, each tube was rinsed with
200 .mu.l of fresh medium and then treated with 200 .mu.l medium
containing 5% xylitol alone or in combination with DispersinB (20
.mu.g/ml). After 3 h incubation at 37.degree. C., 10 .mu.l of 200
.mu.g/ml DispersinB was added to each tube, and tubes were
incubated for additional 5 min to detach biofilm. Serial dilutions
of the cells were plated on tryptic soy agar. The DispersinB
slightly enhanced the inhibitory effect of xylitol on
biofilm-embedded S. epidermidis (FIG. 45).
Example 41
Enhancing Effect of DispersinB.TM. on the Sensitivity of
Biofilm-Embedded Staphylococcus epidermidis to Antimicrobial Enzyme
Glucose Oxidase
[0306] An in vitro biofilm-dispersal assay was performed to
determine the enhancing effect of DispersinB.TM. on the sensitivity
of biofilm-embedded epidermidis to glucose oxidase. S. epidermidis
biofilm was grown in 1.5 ml polypropylene microcentrifuge tubes
(200 .mu.l culture volume), medium containing planktonic cells was
discarded. Further, each tube was rinsed with 200 .mu.l of fresh
medium and then treated with 200 .mu.l medium containing 10 U/ml of
glucose oxidase alone or in combination with 20 .mu.g/ml of
DispersinB. After 3 h incubation at 37.degree. C., 10 .mu.l of 200
.mu.g/ml DispersinB.TM. was added to each tube, and tubes were
incubated for additional 5 min to detach biofilm. Serial dilutions
of the cells were plated on tryptic soy agar. DispersinB enhanced
the inhibitory effect of glucose oxidase on biofilm-embedded S.
epidermidis (FIG. 46).
Example 42
Effect of Dispersinb.TM. N-(1-pyrenyl)maleimide (PyrM) Alone and in
Combination on Staphylococcus epidermidis Biofilm Formation
[0307] In vitro microplate assays were performed to determine the
effect of DispersinB and PyrM combination on the growth of
biofilm-embedded S. epidermidis. Overnight growth of S. epidermidis
in tryptic soy broth (TSB) was used as inoculum. Biofilm was
developed in 12-well microplate in the absence and presence of each
test compound (1 .mu.g/ml DispersinB or 8 .mu.g/ml PyrM) separately
and together (DispersinB+PyrM). The plates were incubated at
37.degree. C. for 24 b. Medium containing planktonic cells in each
well was removed gently and rinsed with sterile water. A known
volume of water was added to each well and sonicated for 30
seconds. The contents of each well was transferred into a sterile
tube, vortexed for a minute, followed by 10-fold serial dilution,
and plated on agar plates using a spreader. After incubating the
plates at 37.degree. C. for 24 h, colony-forming units (CFU) were
counted. Although PyrM was more effective than DispersinB in
inhibiting the growth of biofilm-embedded S. epidermidis, the
combination of DispersinB and PyrM had an enhancing inhibitory
effect on biofilm-embedded S. epidermidis (FIG. 47).
Example 43
Effect of DispersinB.TM. and N,N-(1,2 phenylene)dimaleimide (oPDM)
on Biofilm Formation of Staphylococcus epidermidis
[0308] In vitro microplate assays were performed to determine the
effect of DispersinB.TM. and oPDM combination on the growth of
biofilm embedded S. epidermidis. Overnight growth of S. epidermidis
in tryptic soy broth (TSB) was used as inoculum. Biofilm was
developed in 12-well microplate in the absence and presence of each
test compound (1 .mu.g/ml Dispersing or 625 .mu.g/ml oPDM)
separately and together (DispersinB+oPDM). The plates were
incubated at 37.degree. C. for 24 hours. Medium containing
planktonic cells in each well was removed gently and rinsed with
sterile water. A known volume of water was added to each well and
sonicated for 30 seconds. The contents of each well was transferred
into a sterile tube, vortexed for a minute, followed by 10-fold
serial dilution, and plated on agar plates using a spreader. After
incubating the plates at 37.degree. C. for 24 h, colony-forming
units (CFU) were counted. Although oPDM was more effective than
DispersinB in inhibiting the growth of biofilm-embedded S.
epidermidis, DispersinB and oPDM together had an enhancing
inhibitory effect on biofilm-embedded S. epidermidis (FIG. 48).
Example 44
Antimicrobial Activity of Catheter Coated with DispersinB.TM. and
an Antimicrobial
[0309] Catheter segments (1 cm) were coated with the solution
containing DispersinB.TM. and antimicrobial by dipping and drying
three times. Catheter segments could also be coated sequentially
with an antimicrobial agent and DispersinB.TM.. Antimicrobial
agents such as benzalkonium chloride, sodium usnate,
5-fluorouracil, cefamandole nafate and chitosan were used
separately in combination with DispersinB.TM. for coating. The
solution containing DispersinB and each antimicrobial was prepared
in 10% glycerol as a binding agent. Glycerol could be substituted
with polyethylene glycol.
[0310] The antimicrobial activity of coated catheter was determined
using Kirby-Bauer technique as previously described by Sheretz, et
al. (Antimicrob. Agents Chemother, 33:1174-1178, 1989).
Catheter-associated microorganisms such as Escherichia coli,
Pseudomonas aeruginosa, Staphylococcus epidermidis, S. aureus and
Candida albicans were grown in tryptic soy broth for 18 h at
37.degree. C. An appropriate inoculum of each strain was used to
prepare spread plates. The coated and uncoated sections were then
carefully pressed onto the center of each spread plate. Following
the incubation for 24 h at 37.degree. C., the zone of inhibition
surrounding each section was measured at the aspects of
perpendicular to the long axes. The catheters coated with
DispersinB.TM.-cefamandole nafate and DispersinB.TM.-benzalkonium
chloride showed antimicrobial activity against E. coli, S.
epidermidis and S. aureus (Table 6). The catheters coated with
DispersinB.TM.-5-fluorouracil showed antimicrobial activity against
all the test organisms except C. albicans. However, the catheters
coated with DispersinB-sodium usnate were selectively active
against gram-positive organisms.
TABLE-US-00008 TABLE 6 Antimicrobial activity of catheters coated
with DispersinB .TM. (100 .mu.g/ml) and antimicrobial agents Con.
of antimicrobial agent in the coating Zone of inhibition (mm)
against test organisms Coating solution E. coli P. aeruginosa S.
epidermidis S. aureus C. albicans DispersinB .TM.- 50 mg/ml 27.5 0
44 24 0 Cefamandole nafate DispersinB .TM.- 10 mg/ml 30.5 15.5 42
27.5 0 5-fluorouracil DispersinB .TM.- 10 mg/ml 0 0 23 13.5 0
sodium usnate DispersinB .TM.- 100 mg/ml 3.5 0 23.5 19 10.0
benzalkonium chloride
Example 45
Antibiofilm Activity of DispersinB.TM. and Cefamandole Nafate (CFN)
Combination-Coated Catheters Against Catheter-Associated
Microorganisms
[0311] The antibiofilm activity of DispersinB.TM. and cefamandole
nafate (CFN) combination coated catheters against
catheter-associated bacteria and yeast was determined. Catheters
were coated with DispersinB.TM. (100 .mu.g/ml)-cefamandole nafate
(50 mg/ml). Catheter-associated microorganisms such as Escherichia
coli, Staphylococcus epidermidis and S. aureus were grown in TSB
for 18 h. The coated and uncoated catheter segments were placed in
15 ml tubes separately containing 10 ml TSB inoculated with test
organism. The tubes were incubated in a water bath at 37.degree. C.
with gentle shaking. After 24 h incubation, catheter segments were
washed, sonicated, vortexed and the serial dilutions were plated on
tryptic soy agar. The DispersitB.TM.-CFN combination coated
catheters inhibited >99% E. coli, S. epidermidis and S. aureus
biofilm formation (FIG. 49).
Example 46
Antibiofilm Activity of DispersinB.TM. and 5-fluorouracil (FU)
Combination-Coated Catheters Against Catheter-Associated
Microorganisms
[0312] The antibiofilm activity of DispersinB.TM. and
5-fluorouracil (FU) combination coated catheters against
catheter-associated bacteria and yeast was determined. Catheters
were coated with DispersinB.TM. (100 .mu.g/ml)-FU (10 mg ml).
Catheter-associated microorganisms such as Escherichia coli,
Pseudomonas aeruginosa, Staphylococcus epidermidis, S. aureus and
Candida albicans were grown in TSB for 18 h. The coated and
uncoated catheter segments were placed in 15 ml tubes separately
containing 10 ml TSB inoculated with test organism. The tubes were
incubated in a water bath at 37.degree. C. with gentle shaking.
After 24 h incubation, catheter segments were washed, sonicated,
vortexed and the serial dilutions were plated on tryptic soy agar.
The DispersinB.TM.-FU combination coated catheters inhibited
.gtoreq.99% gram negative and gram-positive bacterial biofilm
formation (FIG. 50), and it inhibited 80% C. albicans biofilm.
Example 47
Antibiofilm Activity of DispersinB.TM. and Sodium Usnate (SU)
Combination-Coated Catheters Against Catheter-Associated
Microorganisms
[0313] The antibiofilm activity of DispersinB.TM. and sodium usnate
(SU) combination coated catheters against catheter-associated
bacteria and yeast was determined. Catheters were coated with
DispersinB.TM. (100 .mu.g/ml)-SU (10 mg/ml). Catheter associated
microorganisms such as Escherichia coli, Pseudomonas aeruginosa,
Staphylococcus epidermidis, S. aureus and Candida albicans were
grown in TSB for 18 h. The coated and uncoated catheter segments
were placed in 15 ml tubes separately containing 10 ml TSB
inoculated with test organism. The tubes were incubated in a water
bath at 37.degree. C. with gentle shaking. After 24 h incubation,
catheter segments were washed, sonicated, vortexed and the serial
dilutions were plated on tryptic soy agar. The DispersinB.TM.-SU
combination coated catheters were more effective in inhibiting
biofilm formation in gram-positive bacteria compared to that in
gram-negative bacteria (FIG. 51).
Example 48
Antibiofilm Activity of DispersinB.TM. and Benzalkonium Chloride
(BKC) Combination-Coated Catheters Against Catheter-Associated
Microorganisms
[0314] The antibiofilm activity of DispersinB.TM. and benzalkonium
chloride (BKC) combination coated catheters against
catheter-associated bacteria and yeast was determined. Catheters
were coated with DispersinB.TM. (100 .mu.g/ml)-BKC (100 mg/ml).
Catheter-associated microorganisms such as Escherichia coli,
Pseudomonas aeruginosa, Staphylococcus epidermidis, S. aureus and
Candida albicans were grown in TSB for 18 h. The coated and
uncoated catheter segments were placed in 15 ml tubes separately
containing 10 ml TSB inoculated with test organism. The tubes were
incubated in a water bath at 37.degree. C. with gentle shaking.
After 24 h incubation catheter segments were washed, sonicated,
vortexed and the serial dilutions were plated on tryptic soy agar.
The DispersinB.TM.-BKC combination coated catheters completely
inhibited biofilm formation in gram-negative as well as
gram-positive bacteria and also in yeast (FIG. 52).
Example 49
Antibiofilm Activity of DispersinB.TM. and Chitosan
Combination-Coated Catheters Against Catheter-Associated
Microorganisms
[0315] The antibiofilm activity of DispersinB.TM. and chitosan
combination coated catheters against catheter-associated bacteria
was determined. Catheters were coated with DispersinB.TM. (100
.mu.g/ml)-chitosan (5 mg/ml). Catheter-associated microorganisms
such as Escherichia coli, Pseudomonas aeruginosa, and
Staphylococcus epidermidis were grown in TSB for 18 h. The coated
and uncoated catheter segments were placed in 15 ml tubes
separately containing 10 ml TSB inoculated with test organism. The
tubes were incubated in a water bath at 37.degree. C. with gentle
shaking. After 24 h incubation, catheter segments were washed,
sonicated, vortexed and the serial dilutions were plated on tryptic
soy agar. The DispersinB.TM.-chitosan combination coated catheters
inhibited 67% E. coli, and >99% S. epidermidis biofilms (FIG.
53).
Sequence CWU 1
1
1511146DNAActinobacillus actinomycetemcomitans strain CU100N
1atgaattata ttaagaaaat tattttatct cttttcctac tgggactatt tagcgtgttg
60aattgttgcg taaaaggcaa ttccatatat ccgcaaaaaa caagtaccaa gcagaccgga
120ttaatgctgg acatcgcccg acatttttat tcacccgagg tgattaaatc
ctttattgat 180accatcagcc tttccggcgg taattttctg cacctgcatt
tttccgacca tgaaaactat 240gcgatagaaa gccatttact taatcaacgt
gcggaaaatg ccgtgcaggg caaagacggt 300atttatatta atccttatac
cggaaagcca ttcttgagtt atcggcaact tgacgatatc 360aaagcctatg
ctaaggcaaa aggcattgag ttgattcccg aacttgacag cccgaatcac
420atgacggcga tctttaaact ggtgcaaaaa gacagagggg tcaagtacct
tcaaggatta 480aaatcacgcc aggtagatga tgaaattgat attactaatg
ctgacagtat tacttttatg 540caatctttaa tgagtgaggt tattgatatt
tttggcgaca cgagtcagca ttttcatatt 600ggtggcgatg aatttggtta
ttctgtggaa agtaatcatg agtttattac gtatgccaat 660aaactatcct
actttttaga gaaaaaaggg ttgaaaaccc gaatgtggaa tgacggatta
720attaaaaata cttttgagca aatcaacccg aatattgaaa ttacttattg
gagctatgat 780ggcgatacgc aggacaaaaa tgaagctgcc gagcgccgtg
atatgcgggt cagtttgccg 840gagttgctgg cgaaaggctt tactgtcctg
aactataatt cctattatct ttacattgtt 900ccgaaagctt caccaacctt
ctcgcaagat gccgcctttg ccgccaaaga tgttataaaa 960aattgggatc
ttggtgtttg ggatggacga aacaccaaaa accgcgtaca aaatactcat
1020gaaatagccg gcgcagcatt atcgatctgg ggagaagatg caaaagcgct
gaaagacgaa 1080acaattcaga aaaacacgaa aagtttattg gaagcggtga
ttcataagac gaatggggat 1140gagtga 11462381PRTActinobacillus
actinomycetemcomitans strain CU100N 2Met Asn Tyr Ile Lys Lys Ile
Ile Leu Ser Leu Phe Leu Leu Gly Leu1 5 10 15Phe Ser Val Leu Asn Cys
Cys Val Lys Gly Asn Ser Ile Tyr Pro Gln 20 25 30Lys Thr Ser Thr Lys
Gln Thr Gly Leu Met Leu Asp Ile Ala Arg His 35 40 45Phe Tyr Ser Pro
Glu Val Ile Lys Ser Phe Ile Asp Thr Ile Ser Leu 50 55 60Ser Gly Gly
Asn Phe Leu His Leu His Phe Ser Asp His Glu Asn Tyr65 70 75 80Ala
Ile Glu Ser His Leu Leu Asn Gln Arg Ala Glu Asn Ala Val Gln 85 90
95Gly Lys Asp Gly Ile Tyr Ile Asn Pro Tyr Thr Gly Lys Pro Phe Leu
100 105 110Ser Tyr Arg Gln Leu Asp Asp Ile Lys Ala Tyr Ala Lys Ala
Lys Gly 115 120 125Ile Glu Leu Ile Pro Glu Leu Asp Ser Pro Asn His
Met Thr Ala Ile 130 135 140Phe Lys Leu Val Gln Lys Asp Arg Gly Val
Lys Tyr Leu Gln Gly Leu145 150 155 160Lys Ser Arg Gln Val Asp Asp
Glu Ile Asp Ile Thr Asn Ala Asp Ser 165 170 175Ile Thr Phe Met Gln
Ser Leu Met Ser Glu Val Ile Asp Ile Phe Gly 180 185 190Asp Thr Ser
Gln His Phe His Ile Gly Gly Asp Glu Phe Gly Tyr Ser 195 200 205Val
Glu Ser Asn His Glu Phe Ile Thr Tyr Ala Asn Lys Leu Ser Tyr 210 215
220Phe Leu Glu Lys Lys Gly Leu Lys Thr Arg Met Trp Asn Asp Gly
Leu225 230 235 240Ile Lys Asn Thr Phe Glu Gln Ile Asn Pro Asn Ile
Glu Ile Thr Tyr 245 250 255Trp Ser Tyr Asp Gly Asp Thr Gln Asp Lys
Asn Glu Ala Ala Glu Arg 260 265 270Arg Asp Met Arg Val Ser Leu Pro
Glu Leu Leu Ala Lys Gly Phe Thr 275 280 285Val Leu Asn Tyr Asn Ser
Tyr Tyr Leu Tyr Ile Val Pro Lys Ala Ser 290 295 300Pro Thr Phe Ser
Gln Asp Ala Ala Phe Ala Ala Lys Asp Val Ile Lys305 310 315 320Asn
Trp Asp Leu Gly Val Trp Asp Gly Arg Asn Thr Lys Asn Arg Val 325 330
335Gln Asn Thr His Glu Ile Ala Gly Ala Ala Leu Ser Ile Trp Gly Glu
340 345 350Asp Ala Lys Ala Leu Lys Asp Glu Thr Ile Gln Lys Asn Thr
Lys Ser 355 360 365Leu Leu Glu Ala Val Ile His Lys Thr Asn Gly Asp
Glu 370 375 3803555DNAActinobacillus ligniersii strain 19393
3gatcacgaga attatgcatt ggaaagttct tatttggaac aacgagaaga aaatgccgtt
60gagaaaaacg gaacctattt caatccgaaa acaaataagc cgtttctcac ttataaacag
120ctcaatgaaa ttatctatta tgccaaagaa cgaaatattg aaattgtgcc
tgaagtcgat 180agcccgaatc atatgacggc gatttttgat cttttaaccc
ttaagcacgg taaggagtat 240gtgaaagggc tgaaatcgcc ttatcttgcc
gaggaaatcg atattaataa ccctgaagcg 300gttgaaatta tcaaaacctt
aatcggtgaa gtgatttata tttttgggca ttccagccga 360cactttcata
tcggcggaga cgaatttagt tatgcggtcg aaaacaatca cgaatttatt
420cgttatgtaa atacgctaaa tgactttatt aataacaaag gactaattac
ccgtatttgg 480aacgacggtt tgattaaaaa caatttaaat gagcttaatc
ggaatatcga aattacttat 540tggagctacg acggt 5554185PRTActinobacillus
ligniersii strain 19393 4Asp His Glu Asn Tyr Ala Leu Glu Ser Ser
Tyr Leu Glu Gln Arg Glu1 5 10 15Glu Asn Ala Val Glu Lys Asn Gly Thr
Tyr Phe Asn Pro Lys Thr Asn 20 25 30Lys Pro Phe Leu Thr Tyr Lys Gln
Leu Asn Glu Ile Ile Tyr Tyr Ala 35 40 45Lys Glu Arg Asn Ile Glu Ile
Val Pro Glu Val Asp Ser Pro Asn His 50 55 60Met Thr Ala Ile Phe Asp
Leu Leu Thr Leu Lys His Gly Lys Glu Tyr65 70 75 80Val Lys Gly Leu
Lys Ser Pro Tyr Leu Ala Glu Glu Ile Asp Ile Asn 85 90 95Asn Pro Glu
Ala Val Glu Ile Ile Lys Thr Leu Ile Gly Glu Val Ile 100 105 110Tyr
Ile Phe Gly His Ser Ser Arg His Phe His Ile Gly Gly Asp Glu 115 120
125Phe Ser Tyr Ala Val Glu Asn Asn His Glu Phe Ile Arg Tyr Val Asn
130 135 140Thr Leu Asn Asp Phe Ile Asn Asn Lys Gly Leu Ile Thr Arg
Ile Trp145 150 155 160Asn Asp Gly Leu Ile Lys Asn Asn Leu Asn Glu
Leu Asn Arg Asn Ile 165 170 175Glu Ile Thr Tyr Trp Ser Tyr Asp Gly
180 1855558DNAActinobacillus actinomycetemcomitans strain IDH781
5gatcatgaaa actatgcgat agaaagccat ttacttaatc aacgtgcgga aaatgccgta
60cagggcaaag acggtattta tattaatcct tataccggaa agccattctt gagttatcga
120caacttgacg atatcaaagc ctatgctaag gcaaaaggca ttgagttgat
tcccgaactt 180gatagtccga atcacatgac ggcgatcttt aaactggtgc
aaaaagacag agggatcaag 240tatcttcaag gattaaaatc acgccaggta
gatgatgaaa ttgatattac taatgctgac 300agtattgctt ttatgcaatc
tttaatgagt gaggttattg atatttttgg cgacacgagt 360cagcattttc
atattggtgg cgatgaattt ggttattctg tggaaagtaa tcatgagttt
420attacgtatg ccaataaact atcctacttt ttagagaaaa aggggttgaa
aacccgaatg 480tggaatgacg gattaattaa aagtactttt gagcaaatca
acccgaatat tgaaattact 540tattggagct atgatggc
5586186PRTActinobacillus actinomycetemcomitans strain IDH781 6Asp
His Glu Asn Tyr Ala Ile Glu Ser His Leu Leu Asn Gln Arg Ala1 5 10
15Glu Asn Ala Val Gln Gly Lys Asp Gly Ile Tyr Ile Asn Pro Tyr Thr
20 25 30Gly Lys Pro Phe Leu Ser Tyr Arg Gln Leu Asp Asp Ile Lys Ala
Tyr 35 40 45Ala Lys Ala Lys Gly Ile Glu Leu Ile Pro Glu Leu Asp Ser
Pro Asn 50 55 60His Met Thr Ala Ile Phe Lys Leu Val Gln Lys Asp Arg
Gly Ile Lys65 70 75 80Tyr Leu Gln Gly Leu Lys Ser Arg Gln Val Asp
Asp Glu Ile Asp Ile 85 90 95Thr Asn Ala Asp Ser Ile Ala Phe Met Gln
Ser Leu Met Ser Glu Val 100 105 110Ile Asp Ile Phe Gly Asp Thr Ser
Gln His Phe His Ile Gly Gly Asp 115 120 125Glu Phe Gly Tyr Ser Val
Glu Ser Asn His Glu Phe Ile Thr Tyr Ala 130 135 140Asn Lys Leu Ser
Tyr Phe Leu Glu Lys Lys Gly Leu Lys Thr Arg Met145 150 155 160Trp
Asn Asp Gly Leu Ile Lys Ser Thr Phe Glu Gln Ile Asn Pro Asn 165 170
175Ile Glu Ile Thr Tyr Trp Ser Tyr Asp Gly 180
1857558DNAHaemophilus aphorophilus strain NJ8700 7gaccacgaaa
attatgcttt agaaagcagg ttgttgaatc agcgggcaga aaacgcaatt 60ttaaataaaa
acggaattta tattaatcct tacaccaata agcctttctt gagttatcaa
120cagttggatg acattaaagc atatgcaaaa ttaaaaggta ttgagcttat
tcccgaatta 180gatagcccga atcacatgac agcgattttt accttattaa
aaaaagaaaa aggaaaaaat 240tatcttcaat cgttaaaatc accacaaaat
gatgaggaaa ttagcattac caatccggac 300agcattgcat ttatgcaatc
cttattaaca gaggtaattc atacctttgg cgatagcacc 360aagcattttc
atattggcgg agatgagttt ggttatgatg aaaatagtaa tcatgaattt
420attacctatg ccaataaatt ggctgatttt ttaagagaaa aaggattaaa
aactcgaatt 480tggaatgatg gtttaattaa aaataccata gatcaattaa
atcctaatat tgaaattacc 540tactggagtt acgacggc 5588186PRTHaemophilus
aphrophilus strain NJ8700 8Asp His Glu Asn Tyr Ala Leu Glu Ser Arg
Leu Leu Asn Gln Arg Ala1 5 10 15Glu Asn Ala Ile Leu Asn Lys Asn Gly
Ile Tyr Ile Asn Pro Tyr Thr 20 25 30Asn Lys Pro Phe Leu Ser Tyr Gln
Gln Leu Asp Asp Ile Lys Ala Tyr 35 40 45Ala Lys Leu Lys Gly Ile Glu
Leu Ile Pro Glu Leu Asp Ser Pro Asn 50 55 60His Met Thr Ala Ile Phe
Thr Leu Leu Lys Lys Glu Lys Gly Lys Asn65 70 75 80Tyr Leu Gln Ser
Leu Lys Ser Pro Gln Asn Asp Glu Glu Ile Ser Ile 85 90 95Thr Asn Pro
Asp Ser Ile Ala Phe Met Gln Ser Leu Leu Thr Glu Val 100 105 110Ile
His Thr Phe Gly Asp Ser Thr Lys His Phe His Ile Gly Gly Asp 115 120
125Glu Phe Gly Tyr Asp Glu Asn Ser Asn His Glu Phe Ile Thr Tyr Ala
130 135 140Asn Lys Leu Ala Asp Phe Leu Arg Glu Lys Gly Leu Lys Thr
Arg Ile145 150 155 160Trp Asn Asp Gly Leu Ile Lys Asn Thr Ile Asp
Gln Leu Asn Pro Asn 165 170 175Ile Glu Ile Thr Tyr Trp Ser Tyr Asp
Gly 180 1859555DNAActinobacillus pleuropneumoniae strain IA5
9gatcacgaga attatgcatt ggaaagttct tatttggaac aacgagaaga aaatgcgacc
60gagaaaaacg gaacctattt caatccgaaa acaaataagc cgtttctcac ttataaacag
120ctcaatgaaa ttatctatta tgccaaagaa cgaaatattg aaattgtgcc
tgaagtcgat 180agcccgaatc atatgacggc gatttttgat cttttaaccc
ttaagcacgg aaaggaatac 240gtaaaagggc taaaatcgcc ttatatcgcc
gaggaaatcg atattaataa ccccgaagcg 300gttgaagtta ttaaaacctt
aatcggtgaa gtgatctata ttttcggaca ttcaagccgg 360catttccata
tcggcggaga tgaatttagc tatgcggtcg aaaataatca tgaatttatt
420cggtatgtga ataccttaaa tgattttatc aattccaaag ggctaattac
ccgtgtttgg 480aatgacggtt tgatcaaaaa caacttaagc gaactcaata
aaaacattga aatcacttac 540tggagctacg acggt 55510185PRTActinobacillus
pleuropneumoniae strain IA5 10Asp His Glu Asn Tyr Ala Leu Glu Ser
Ser Tyr Leu Glu Gln Arg Glu1 5 10 15Glu Asn Ala Thr Glu Lys Asn Gly
Thr Tyr Phe Asn Pro Lys Thr Asn 20 25 30Lys Pro Phe Leu Thr Tyr Lys
Gln Leu Asn Glu Ile Ile Tyr Tyr Ala 35 40 45Lys Glu Arg Asn Ile Glu
Ile Val Pro Glu Val Asp Ser Pro Asn His 50 55 60Met Thr Ala Ile Phe
Asp Leu Leu Thr Leu Lys His Gly Lys Glu Tyr65 70 75 80Val Lys Gly
Leu Lys Ser Pro Tyr Ile Ala Glu Glu Ile Asp Ile Asn 85 90 95Asn Pro
Glu Ala Val Glu Val Ile Lys Thr Leu Ile Gly Glu Val Ile 100 105
110Tyr Ile Phe Gly His Ser Ser Arg His Phe His Ile Gly Gly Asp Glu
115 120 125Phe Ser Tyr Ala Val Glu Asn Asn His Glu Phe Ile Arg Tyr
Val Asn 130 135 140Thr Leu Asn Asp Phe Ile Asn Ser Lys Gly Leu Ile
Thr Arg Val Trp145 150 155 160Asn Asp Gly Leu Ile Lys Asn Asn Leu
Ser Glu Leu Asn Lys Asn Ile 165 170 175Glu Ile Thr Tyr Trp Ser Tyr
Asp Gly 180 18511361PRTActinobacillus actinomycetemcomitans 11Asn
Cys Cys Val Lys Gly Asn Ser Ile Tyr Pro Gln Lys Thr Ser Thr1 5 10
15Lys Gln Thr Gly Leu Met Leu Asp Ile Ala Arg His Phe Tyr Ser Pro
20 25 30Glu Val Ile Lys Ser Phe Ile Asp Thr Ile Ser Leu Ser Gly Gly
Asn 35 40 45Phe Leu His Leu His Phe Ser Asp His Glu Asn Tyr Ala Ile
Glu Ser 50 55 60His Leu Leu Asn Gln Arg Ala Glu Asn Ala Val Gln Gly
Lys Asp Gly65 70 75 80Ile Tyr Ile Asn Pro Tyr Thr Gly Lys Pro Phe
Leu Ser Tyr Arg Gln 85 90 95Leu Asp Asp Ile Lys Ala Tyr Ala Lys Ala
Lys Gly Ile Glu Leu Ile 100 105 110Pro Glu Leu Asp Ser Pro Asn His
Met Thr Ala Ile Phe Lys Leu Val 115 120 125Gln Lys Asp Arg Gly Val
Lys Tyr Leu Gln Gly Leu Lys Ser Arg Gln 130 135 140Val Asp Asp Glu
Ile Asp Ile Thr Asn Ala Asp Ser Ile Thr Phe Met145 150 155 160Gln
Ser Leu Met Ser Glu Val Ile Asp Ile Phe Gly Asp Thr Ser Gln 165 170
175His Phe His Ile Gly Gly Asp Glu Phe Gly Tyr Ser Val Glu Ser Asn
180 185 190His Glu Phe Ile Thr Tyr Ala Asn Lys Leu Ser Tyr Phe Leu
Glu Lys 195 200 205Lys Gly Leu Lys Thr Arg Met Trp Asn Asp Gly Leu
Ile Lys Asn Thr 210 215 220Phe Glu Gln Ile Asn Pro Asn Ile Glu Ile
Thr Tyr Trp Ser Tyr Asp225 230 235 240Gly Asp Thr Gln Asp Lys Asn
Glu Ala Ala Glu Arg Arg Asp Met Arg 245 250 255Val Ser Leu Pro Glu
Leu Leu Ala Lys Gly Phe Thr Val Leu Asn Tyr 260 265 270Asn Ser Tyr
Tyr Leu Tyr Ile Val Pro Lys Ala Ser Pro Thr Phe Ser 275 280 285Gln
Asp Ala Ala Phe Ala Ala Lys Asp Val Ile Lys Asn Trp Asp Leu 290 295
300Gly Val Trp Asp Gly Arg Asn Thr Lys Asn Arg Val Gln Asn Thr
His305 310 315 320Glu Ile Ala Gly Ala Ala Leu Ser Ile Trp Gly Glu
Asp Ala Lys Ala 325 330 335Leu Lys Asp Glu Thr Ile Gln Lys Asn Thr
Lys Ser Leu Leu Glu Ala 340 345 350Val Ile His Lys Thr Asn Gly Asp
Glu 355 36012377PRTActinobacillus pleuropneumoniae 12Met Lys Lys
Ala Ile Thr Leu Phe Thr Leu Leu Cys Ala Val Leu Leu1 5 10 15Ser Phe
Ser Thr Ala Thr Tyr Ala Asn Ala Met Asp Leu Pro Lys Lys 20 25 30Glu
Ser Gly Leu Thr Leu Asp Ile Ala Arg Arg Phe Tyr Thr Val Asp 35 40
45Thr Ile Lys Gln Phe Ile Asp Thr Ile His Gln Ala Gly Gly Thr Phe
50 55 60Leu His Leu His Phe Ser Asp His Glu Asn Tyr Ala Leu Glu Ser
Ser65 70 75 80Tyr Leu Glu Gln Arg Glu Glu Asn Ala Thr Glu Lys Asn
Gly Thr Tyr 85 90 95Phe Asn Pro Lys Thr Asn Lys Pro Phe Leu Thr Tyr
Lys Gln Leu Asn 100 105 110Glu Ile Ile Tyr Tyr Ala Lys Glu Arg Asn
Ile Glu Ile Val Pro Glu 115 120 125Val Asp Ser Pro Asn His Met Thr
Ala Ile Phe Asp Leu Leu Thr Leu 130 135 140Lys His Gly Lys Glu Tyr
Val Lys Gly Leu Lys Ser Pro Tyr Ile Ala145 150 155 160Glu Glu Ile
Asp Ile Asn Asn Pro Glu Ala Val Glu Val Ile Lys Thr 165 170 175Leu
Ile Gly Glu Val Ile Tyr Ile Phe Gly His Ser Ser Arg His Phe 180 185
190His Ile Gly Gly Asp Glu Phe Ser Tyr Ala Val Glu Asn Asn His Glu
195 200 205Phe Ile Arg Tyr Val Asn Thr Leu Asn Asp Phe Ile Asn Ser
Lys Gly 210 215 220Leu Ile Thr Arg Val Trp Asn Asp Gly Leu Ile Lys
Asn Asn Leu Ser225 230 235 240Glu Leu Asn Lys Asn Ile Glu Ile Thr
Tyr Trp Ser Tyr Asp Gly Asp 245 250 255Ala Gln Ala Lys Glu Asp Ile
Gln Tyr Arg Arg Glu Ile Arg Ala Asp 260 265 270Leu Pro Glu Leu Leu
Ala Asn Gly Phe Lys Val Leu Asn Tyr Asn Ser 275 280 285Tyr Tyr Leu
Tyr Phe Val Pro Lys Ser Gly Ser Asn Ile His Asn Asp 290 295 300Gly
Lys Tyr Ala Ala Glu Asp Val Leu Asn
Asn Trp Thr Leu Gly Lys305 310 315 320Trp Asp Gly Lys Asn Ser Ser
Asn His Val Gln Asn Thr Gln Asn Ile 325 330 335Ile Gly Ser Ser Leu
Ser Ile Trp Gly Glu Arg Ser Ser Ala Leu Asn 340 345 350Glu Gln Thr
Ile Gln Gln Ala Ser Lys Asn Leu Leu Lys Ala Val Ile 355 360 365Gln
Lys Thr Asn Asp Pro Lys Ser His 370 3751322DNAArtificialDNA Primer
UTCF1 13gtgcaatcca ttaattttgg tg 221419DNAArtificialDNA Primer UTCR
14catacgtatc ctccaagcc 19158PRTArtificialLinker sequence 15Gly Gly
Gly Ser Gly Gly Gly Ser1 5
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